1. Primary prevention avoids the development of a disease. Promotion activities such as health education are considered primary prevention. True or False (Explain)
It is true that primary prevention avoids the development of a disease. Primary prevention involves all the measures that are taken to prevent any disease from occurring through reduction of the risk factors (Bloom, 1996) Risk factors are the conditions that when present, they encourage the development of a particular disease. Risk factors also encompass certain behaviors and exposures that have a potential of leading to occurrence of a given disease.
Interventions that are taken may include but not limited to, alteration of behavior, reducing the disease exposure through vaccination and other methods that are directed towards enhancing immunity. Primary prevention minimizes the occurrence of a disease mainly through addressing risk factors or through improving resistance. For example practices such as regular brushing of teeth prevents against dental carries.
Specific causes of diseases are the main target in primary prevention but sometimes a broader approach that aims at enhancing health promotion activities. Another focus is on ensuring safe environment and improving the resistance of hosts. Behaviors can for instance include regular physical exercise that is important in the case of prevention of obesity. Communicable diseases can be avoided by prevention that involves immunization such as it is in the case of influenza (Bloom, 1996) .It is evident that primary prevention is important in reduction of both prevalence and incidence of a particular disease.
2. Public health functions are functions that provide services to the individual. True or False (Explain)
It is false that the functions of public health are geared towards provision of health services to an individual. Public health as a science aims and art aims at disease prevention, life prolonging and promotion of health under coordinated effort that assist communities to make informed decisions on health safety (American Public Health Association, 1971) .The concern rests on the threats against health on the basis of analysis of population health. It involves integrated approaches in order to manage and prevent diseases, mechanical injuries among other conditions of health through case surveillance and promotion of healthy environments and behaviors. Public health recognizes the fact that many diseases can be prevented through adoption of non-medical methods that are just simple.(Royal Society for Public Health, 2009). For instance, hand washing is a simple act which enhances prevention of contagious diseases. Communication programs of public health such as condom distribution, vaccination programs represent effective public health interventions. These measures contribute greatly to healthy population and promote increased life expectancy. Public health services are targeted towards prevention instead of focusing in the actual treatment of diseases.
Public health compliments clinical medicine in the sense that it does not focus on the health of merely a sole individual but is concerned with populations. Professionals in health care get involved in provision of counseling and pharmaceutical support in an attempt to help individuals quit unhealthy behaviors such as smoking
Public health relies on multi-sectorial coordinated partnerships to ensure that the population healthy is not sabotaged. The partnerships that are established across many sectors are important in specifying the duties and responsibilities of the various institutions that are crucial in enhancing public health programs and roles. For instance in the management and preparation of the H1N1 pandemic, public health services were provided in partnership with clinical medicine services. Public health developed protocols of preparedness of the pandemic and guidelines just prior to H1N1 influenza virus (Royal Society for Public Health, 2009).
4. Established in 1965, the Administration on Aging is one of the largest providers of home and community based care for older persons. True or False (Explain)
The aging administration that was established in 1965 is responsible for community and home based services and also programs that are related to aging. The AoA also has a focus of assisting to empower the Americans at their later old age to enable them make decisions from an informed perspective about the options of health care. The administration is concerned with the protection of the elderly rights in an attempt to prevent any form of abuse, exploitation, neglect and generally make the society to establish effective plans for the aging population.
The United States involvement in matters concerning the welfare of the aged started much earlier even before the establishment of the AoA in 1965.in the year1935, the act on social security had a provision for assistance of the aged. The act also provided for insurance for the old age survivors. It was in the year 1950, when President Truman conducted the first aging international conference (United States, United States, United States, United States, & United States, 1951). After two years, federal funds for the elderly on programs of social services were provided. During the year 1956, a special staff on aging was established under secretary of education, welfare and health.
The administration provides a variety of services that includes day care for adults, legal and financial assistance and also provides transportation services to places of medical appointments, health screenings, counseling, education and also delivery programs that involve the distribution of hot foods to senior settings where many of the aged adults gather to pick the foods (United States, 1995). Preventive services that mainly provide education about the advantages of positive choices of lifestyles, physical activities and the importance of attending regular screenings are provided in an organized manner that is aimed at preventing chronic diseases. The rights of aged vulnerable persons are protected especially through development of programs that seek to investigate and provide responses to complaints. Grants are also given to different groups and /or institutions that conduct the services across the United States and also in other states. In addition AoA assists the aged and their respective families to comprehend different housing options, nursing of homes and assisted living including provision of information that creates awareness of the free toll-telephone that connects the callers with the service providers in their locality.
5. The Affordable Care Act will limit access to health care services. True or False (Explain)
It is a misconception that the affordable care will limit access of health care services. The act makes the existing health insurance forms strong and builds new health insurance that is largely affordable for people and families that lack employer coverage (Davidson, 2013).An attempt to expand the coverage of medical services the act, has restructured Medicaid and enabled it to cover united states citizens and those people that legally reside in the united states and have less than 133% family incomes when their poverty is related to the federal level (United States & United States ,2012).
As from the year 2014, all employers will be required to offer insurance failure of which they will be forced to purchase it directly from the market of health insurance. The individuals will have an opportunity to acquire qualified and affordable health benefits in the well laid down plans that guide the operations in the insurance market. Provision of tax credits is seen as an effort that will allow the middle class citizens to afford insurance. The credit on tax is progressively advance able so that it lowers the payments on premiums every month instead of unnecessary delays that existed before the act especially that of waiting for the time of tax. The credit can be refunded and this allows the middle income citizens and families to access the maximum benefit of the credit. The middle level Americans can reap from reductions in cost sharing.
The affordable care act targets to strengthen the workforce involved in primary health care service chain. In the act, new incentives are provided that aims at expansion of the doctors involved in provision of primary care. The number of physicians and nurses is also to be increased. The act seeks to provide funding for payments of loans and scholarships for nurses and doctors providing health care in areas that are underserved. The introduction of a program that provide for forgiveness in payments of loans taken by doctors (United States & United States, 2012), is meant to eradicate the shortages of health professionals especially in the areas that are underserved.
6. Advance directives are written directions outlining your wishes if you are in an accident and are unable to make a decision at that time. True or False (Explain)
It is false to argue that advance directives cannot guide the process of decision making. The advance directives describe the preferences of a patient regarding treatment in case of an accident or a serious illness (King, 1996). The directives simply provide binding instructions that help to avoid a situation of confusion during treatment. The directives are legally binding and are able to communicate to the doctors on the kind of treatment that the patient wants to receive. These directives are mainly applicable to adults, since children cannot make decisions regarding complex situations as in the case of a coma or any other serious ailment.
The advance directives have the ability to cover treatment instructions to some extent beyond which they become limiting. This is the reason why the directives work best when they are used simultaneously. Physicians have a significant role to play especially in guiding the planning process for advance care (National Cancer Institute U.S, 2000). Doctors are required to make it a usual routine to subject all their patients, adults, to prior formulation of advance instructions and allow the patients to carry out necessary adjustments and corrections over different periods of time. Routine update of the advance directives is beneficial to the patients because it gives them peace of mind and confidence based on a since of control regarding their treatments in the future. The physicians are advised also to carry out advance planning for their own use.
In addition, it is crucial to Marshal Support for advance care plans and decisions by use of formal documents as in the case of advance directives .Advance directives may be in form of living wills, in which an individual instructs on the medical interventions that he desires to be adopted during treatment. Another form is that of a power of attorney in which the patient chooses a particular individual to act as the agent in making decisions of health care in circumstances when the patient is unable to make decisions.
2. What are the determinants of health?
Determinants of health refer to the range of social, personal, economic and also environmental factors that have an influence on the health status. The interrelationships of these determinants of health are significant in the determination of the status of health of population or an individual (Evans & others,1994).The kind of policies that are formulated at state, local or federal level influence population and individual health. For instance, tax increases on tobacco leads to improved health of a population trough reduction in the proportion of the population that uses products from tobacco. There are policies which have an influence on a population for long periods of time and as a result help to shape the behaviors of individuals. Social determinants represent physical factors of the environment where people live, play, age, work and also even where they are born. These factors influence the quality of outcomes of life and health of a population. For instance, exposure to emerging technologies such as the cell phones may significantly influence the health of a particular group of people that are frequent users. Health outcomes are worsened by close association among the individuals and poor physical environment. For instance, many people in America stay in places that have hazardous levels of pollutants that degrade the ozone layer. Higher ozone pollution implies high asthma prevalence among children and adults. Asthma is even worse in children in areas where air quality is poor (Evans& others, 1994).
Genetic and biological factors cause varied effects on particular population that in some other populations. Elderly people are more vulnerable to poor conditions of health than young individuals due to the biological effects that come with aging. A common example of is sickle cell anemia, the gene for sickle cell is common among people that are descendants from the countries of west Africa and central America. Carrying BRCA1 and/or BRCA2 increases susceptibility to breast cancer and cancer of the ovaries respectively (Marmot, 2006).
The quality and access to health services affects health. Limited or lack of access of health services has a great impact on a person’s health. For instance, those individuals that lack health insurance have a lower likelihood of participation in preventive care and they are also likely to slow down the process of medical treatment. Poor health services are greatly as a result of high costs, unavailability, unmet needs, and unnecessary hospitalizations among others.
3. Why was the Medicare Rural Hospital Flexibility Program (MRHP) created?
The essence of the rural flexibility hospital program was to closely work with hospitals in the rural areas in order to strengthen infrastructure especially that of rural health. The main target is based on increasing efficiency and effectiveness of rural and local programs concerning health. The program enables small hospitals flexibility of reconfiguring operations and obtaining licenses to make them (CAHs).reimbursement that is cost based for acute outpatient and inpatient Medicare services is catered for in the program(United States & United States ,2012). The program also promotes development of health networks in rural areas and is concerned with implementation of very broad incentives aimed at strengthening infrastructure for rural health care. New provisions concerning Medicare enable greater flexibility by allowing CAHs to include up to twenty five beds that are designated acute care or those that are for post-acute care. The Medicare law in addition raises the payment for outpatient and inpatient services provided to beneficiaries of Medicare by CAHs, above the initial 100% to the new 101 % (United States & United States, 2012). The new law of Medicare is mainly for increasing the health care services viability in rural areas. Any hospital that needs to be designated as a CAH must submit their application to the health facilities certification and licensing. The application forms are distributed to hospitals that have shown interest in CAH conversion in either a formal or informal manner.
Hospitals designated as critical access hospitals are given the provider status they need but opt to rebuild in other new locations which do not meet the requirements of the 35-mile distance that is provided for, receive similar treatment just like when it would be in the circumstances that they were to build a facility or replacement facility in their initial locations. The new facility designated as CAH must follow a similar criteria that actually applied to its original designation state. It has to serve not less than 75% of same service area and have the potential to provide above 75% health care services and also be in a position to utilize not less than 75% of similar staff in its new location (United States & United States, 2012).
Hospitals under the critical access programs are required to have at the worst, one physician. The physician is not necessarily needed to be on-site. The midlevel practitioners are an independent constituent from the other medical staff. These professionals can however give direct services to the patients. CAHs can provide direction by a physician to a limited level since such provisions are very flexible.
4. What is Medical Informatics?
Health informatics are concerned with information use in provision of health care(European Federation for Medical Informatics ,1997).The informatics create a transformation in health care through analysis and evaluation of information and systems of communication. Informaticians utilize knowledge on patient health care in combination with the knowledge on the methods, concepts and tools of health informatics.
Clinician’s partner with information technology and other health care professionals in the development of informatics tools geared towards promotion of patient health care which is efficient, timely, effective, equitable, patient centered and safe.
There are certifications of informatics that are available and which play a very pertinent role in allowing the professionals to obtain recognition and distinction from other professions. IT technical, project management and clinical understanding are subject to exam tests that are aimed at representing typical workload.
5. Define Medical Ethics and its role in the delivery of healthcare
Medical ethics refers comprises moral principles that are based on application of values and judgments involved practice of medicine (Torr, 2000). The discipline of medical ethics includes practical application that is a requirement for all professionals in the field of health sciences. It also involves theological, historical and philosophical perspective.
In circumstances when moral values are in conflict, they pose an ethical dilemma. At times, good medical solutions may not be available. At such situations, values of medical staff may contradict those values held by a patient, non-medical community and even the family. Conflicts at times occur between the professionals of health care (Egendorf, 2005).This situation is evident especially when autonomy principles and those of beneficence collide in circumstances that a patient rejects for instance rejection of blood transfusion.
Medical ethics are very crucial in aspects of autonomy. The perspective of autonomy embraces recognition of the rights that individuals have towards self-determination. Morals of society require that individuals be given an opportunity to make decisions from informed perspective about personal issues. Observation of autonomy forms a basis to define quality in healthcare in terms of outcomes instead of medical practitioners. .Autonomy observance provides grounds under for advance directives and consent. People with psychiatric condition for example delirium and/or clinical depression lack the capacity of making decisions regarding end of life. A request for rejection of treatment may be necessary under these circumstances.
6. Please list and define the most common mental health disorders
Mental disorders include various conditions that are largely described as mental illness. The disorders range from mood disorders, anxiety disorders, psychotic disorders, eating disorders, addiction disorders and impulse control disorders and personality disorders (Ruggiero, 2008).
Persons with disorders of anxiety respond to situations or objects with fear or dread and also with evident nervousness, physical signs such as sweating and faster heartbeat(Ruggiero, 2008).The disorders of anxiety are diagnosed when a person’s response to a situation is not appropriate, cannot not exert control over the situation or normal functioning is hindered by the anxiety. These disorders include specific phobia, social anxiety, stress disorder and compulsive disorder. Mood disorders include feelings that persist and this may be of sadness, happiness or during fluctuations of feelings between happiness and sadness. Depression, mania and bipolar are examples of mood disorders.
Distorted thinking and awareness are caused by psychotic disorders (Heath, 2005). Hallucinations are a form of this disorder and involve experience of unrealistic sounds or images. Delusions and false voices heard and represent falsehoods but they are accepted due to illness. An example of this disorder is schizophrenia.
Persons with disorders of impulse control face challenges in resisting impulses, urges that push them towards performing harmful acts against themselves and/or other persons. Pyromania, compulsive gambling, kleptomania are good examples of disorders in impulse control (Heath, 2005).Drugs and alcohol represent the common addiction objects. Persons suffering from personality disorders normally are distressed and they cause problems in social places. The patterns of thinking of these people greatly become different from what the society expects of them. A good example is that evident in persons that are affected by antisocial disorders.
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