Thursday, December 26, 2019

The Low Service Utilization Groups - 990 Words

Table 3 presents the results of multinomial regression models predicting membership into the moderate- and high- service utilization groups. The low service utilization group is the reference group. The multivariate analyzes control for indicators representing individual-level characteristics, foster care experiences, and child welfare system factors. Furthermore, these analyzes suggest that the results reported in Table 2 are robust. Child welfare system factors Receipt of services is significantly different for youth in states that have extended foster care policies compared to states that have not extended foster care policies. Youth in states that have extended foster care policies is 16% more likely to be in the moderate service group and 28% less likely to be in the high service group compared to youth in the lower services group. Receipt of services for youth in states that deliver state-administered or centralized child welfare services are significantly different from county-administered or hybrid-administered child welfare states. Youth in state-administered states is 91% more likely to be in the high service group. Youth who are placed in large metropolitan areas are significantly less likely to be in the moderate (26% less likely) or high (24% less likely) service groups compared to youth in smaller metropolitan areas. In contrast to large metropolitan areas, those in large fringe areas are not significantly different from the smaller metropolitanShow MoreRelatedEconomic Issues Simulation Paper1227 Words   |  5 Pageswell balanced health insurance plan that will work for there group of people. I am Jamie Ruth, I am the Vice President, Strategy and Financial Planning at Castor Collins. My duties include pricing plans and setting insurance premiums for our potential clients. Castor Collins was approached by two companies looking for employer insurance and both companies have a set rate their employees are able to pay for premiums since both groups will have to pay for his or her own insurance. The first companyRead MoreEconomic Issues Simulation Essay1164 Words   |  5 Pagesinclude pricing plans and setting insurance premiums for our potential clients. Castor Collins was approached by two companies looking for employer insurance and both companies have a set rate their employees are able to pay for premiums since both groups will have to pay for his or her own insurance (Axia College, 2006). The first company is Constructit that consist of 1,000 people and E-Editors that consist of 1,600 people. It is up to my team to come up with a plan the meets Constructit $4,000 maxR ead MoreHealth Literacy Impact On National Healthcare Utilization1746 Words   |  7 PagesHealth Literacy Impact on National Healthcare Utilization Background: Health literacy presents a huge challenge in the delivery of effective healthcare and quality outcomes. We evaluated association between low health literacy and healthcare utilization. Methods: Database analysis utilized Medical Expenditure Panel Survey(MEPS) from 2005-2008 which provides national representative estimates of healthcare utilization and expeniture. Health literacy scores were calculated based on a validated predictiveRead MoreEconomic Issues Simulation1130 Words   |  5 Pagesemployees are smokers and 13.5 % of the group suffer from a respiratory illness or disease. Another significant risk factor is obesity. Obesity is a disease that affects 39% of the workers and these employees are also at risk for illness and diseases linked to obesity. 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The implementation of Primary health Care in 1979 resulted in some progress in basic delivery of healthcare services for the poor Access to health care services in the Philippines is limited by financial and social barrier. There are widespread disparities of coverage rates for many public health programs. In basic program like child immunization, 70% of local government units haveRead MoreEssay about Posttraumatic Stress Disorder in Veterans1115 Words   |  5 Pagesit is the first national study of VA non-mental health medical service utilization in veterans returning from Iraq and Afghanistan. The findings are important because in the population studied the soldiers who were found to have mental health issues used all types of non-mental health services than those with no diagnosis. Veterans diagnosed with PTSD had the greatest utilization in all service categories. One million of the service men and women who have returned from war zones in Iraq and Afghanistan

Wednesday, December 18, 2019

American Presence on German Culture Essay - 1887 Words

In February of 1945, an unconditional surrender was written up, and to be presented to the successor of Adolf Hitler. Admiral Karl Doenitz signed this surrender in May of 1945 at the Yalta conference where Joseph Stalin, Franklin Roosevelt, and Winston Churchill would identify a means to the end. At the time, Admiral Doenitz had his military commanders assume the government positions in Germany until a new government was later established. The agreements outlined in the surrender at the Potsdam Conference between July and August of 1945 were later fulfilled since no peace conference was held to further diagram the future of Germany. The agreement at the Yalta conference is what eventually shaped the outcome of Germany’s future from†¦show more content†¦In the process of Russia laying its claim to other countries, they attempted to take over Greece as well, but the British arrived just in time to prevent the takeover. Russia had already expanded so far into the ot her European nations that it was somewhat inflated. This caused a significant thinning of Russian forces in Greece, making it less difficult for Great Britain to force them out. This could have led to a different turn of events in the near future if Greece had turned communist at that time. Only speculation and the entertainment industry should expand upon this. The Division of a Nation With the division of Germany between the allied forces, came the commencement of the divided sectors. America now occupied their sector of Germany to the South West enveloping all of Bavaria and some of the smaller surrounding areas. After the halt of forces after the surrender of Germany to the Allied Nations, Russia still had the intention of proceeding forward, but with the United States dropping the two nuclear warheads on Nagasaki and Hiroshima, Russia decided to halt their push into Europe further, in the fear that they too would undergo an attack to prevent a further threat. They began research on ways to counter the new threat of nuclear weaponry, and soon armed themselves with their own nuclear weapons. Thus began The Cold War, and the rivalry between Russia, and America wouldShow MoreRelatedCase Study on Walmart681 Words   |  3 Pagesregarding the manner in which a company approaches (and fails miserably) in expanding operations outside the United States pertains to WalMarts endeavor to open the German market. 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Monday, December 9, 2019

Maternal Health

Question: Write an essay answering the following question:What are the possible explanations for failure to advance maternal, health globally and what needs to be done to improve the situation? Briefly describe whether there is evidence available of what needs to be done, and then discuss whether, or why not, this evidence is being applied in practice. Illustrate with a case study from a particular country, whilst also discussing the emerging debates or next steps in this agenda.This assignment requires that you select one of the topics below. You are expected to critically examine the question presented and put forward an argument drawing on your conceptual understanding from the course and using the literature to support your response. illustrate aspects of your discussion through a country case study but this should NOT be the main focus of the assignment. A broader discussion of the topic with a global focus is required. Answer: The term maternal age is defined as the age of the mother during the time of delivery of the offspring. According to Benzies (2008), the maternal health is not an issue associated with women rather it is about the uprightness of communities, nations and the societies and also the well-being of every single individual whose prospects of life depends completely on a healthy mother. According to (Kahraman et al. 2000), the global society is not yet so advanced and insufficiently galvanized in terms of addressing neonatal and maternal mortality. Certain areas in the healthcare sector and the government sector needs to be improved in order to reduce this complication. In this context, we are going to discuss the failure to advances in maternal health globally and interventions to improve these (Pearson et al., 2000). Political will and strong leadership make innovative, cost-efficient interventions possible. Because women are often marginalized economically, politically and socially, sustained leadership on gender equality is required to advance maternal health. Strong leadership at the highest levels promotes accountability within ministries and enables them to find reliable partners to drive and champion progress in maternal health (Fisk Atun, 2008). In order to reduce the ill effects or the factors that affect advanced maternal health, the first thing that needs to be done is the identification of the factors that contributes to the negative impact of the advanced maternal health. The main two factors that are accountable for the failure of the advanced maternal and neonatal health are both the global donor community and national governments (Aldous Edmonson,1993). As stated by Davis et al. (1989), the adaptation of the eight Millennium Development goal was for the improvement in the health areas. The MDG 5 target involved the achievement of universal access to reproductive health but inadequate funding for family planning was the key failure in fulfilling commitments in order to improve the reproductive health of women. (Jacobsson et al., 2004). The major causes of stillbirth vary by gestational age. Infection is the most common contributor between 24 and 27 weeks' gestation, and unexplained stillbirth is the most common contributor after 28 weeks.In the study by Fretts,rates of unexplained late fetal loss were more pronounced among women aged 35 years or older. This rate is similar to that reported among women aged 45 years and older in a population-based Swedish study. Together, these studies clearly suggest a multifactorial cause of stillbirth and a clear need for prospective studies that include lifestyle and socioeconomic risk factors (Croen et al., 2007). One of the study done by, Huang and his colleagues reveals that 225 million women yet to meet the requirement for modern contraception. Moreover, poor sexual and reproductive health reported to be almost around fourteen percent. One of the major failures of maternal health is that in certain developing nations ninety five percent of the adolescent females are forced to get married. Thus, at this age maternal reproduction can lead to complications where they have not reached the full potential. Such actions lead to death of the adolescent. As stated by Dong et al. (2013), the other barriers include feeble health systems, elevation of inequalities in access and exploitation of reproductive and sexual health services, poor excellence of such services, ingrained gender inequalities, and cultural challenges. (Bauer et al., 2013). Huang and his colleagues are to be highly praised for the width of their evaluation, which involves thirty seven studies from four different continents accounted in five languages. Although medical, methodological and numerical heterogeneity banned meta-analysis, Huang and his colleaguesdiscovered that seventy seven percentages of the thirty one retrospective cohorts learning and all six of the case manage studies point out a statistically important connection between stillbirth rate and advanced maternal age. As stated by Huisman et al. (2013), they established an alike connection in all fifteen populace based on cohort studies. They accomplished that advanced maternal age credible has a self-governing result on stillbirth (Dong et al., 2013). One of the majority severe challenges in conducting assessments in this part is the inconsistency in characterizations of advanced maternal age and the threshold for accounting stillbirth.At a minimum, consensus about definitions and standardized reporting across jurisdictions would lead to more definitive results from systematic reviews. According to Donofrio et al. (2014), additional study variability arises from differences in health care and cultural contexts, which are not sufficiently captured in epidemiologic or hospital-based administrative data sets. This limits the ability to generalize findings to other populations. However, as Huang and colleagues8correctly point out, there remains a great deal to learn about the impact of lifestyle and socioeconomic factors on stillbirth risk. Although large, prospective studies that include information about pregnancy health of the mother and father, maternal stress and socioeconomic factors are expensive, a clear understanding of the r isk of stillbirth will require this level of investment in research (Carey, 2015). In order to reduce these gaps and bring about improvement in the maternal and neonatal health cost for the package of sexual and also the reproductive health including modern contraception could impact on the reduction of pregnant related causes and neonatal deaths. Secondly, in order to delay the age of the childbearing education and paid employment plans should be implemented. The last and one f the significant intervention that can change the whole structure of reproductive health would be the attendance of births delivery with skilled health care professionals. The intervention policies of advanced maternal health globally would involve the following strategies strengthening of the skills and also the assistance of the local advocates that would enable nations to elevate the use of the health saving medical interventions, awareness of the overlooked factors associated with this problem for the maternal and the newborn should be raised and also expansion of the effective and essential medicines. A global agreement should be designed on a set of consistent standards for the goal of health and also measurements. Moreover, these measurements would help to plan, monitor and informed verdict making (Sliwa et al., 2006). To address the main risk factors for newborn and maternal mortality, practices should be adapted for obtainable preventive and healing tools, technologies, and treatment as well as expand new ones which would be more effectual and reasonable and would be additional readily customary for families and health practitioners in rural and society clinics, hospitals and health centers. These involve ways to treat infant infections by means of easy antibiotic treatment regimens, handle postpartum hemorrhage and sanitize the umbilical cord (Wanderer et al., 2013). The evidence reflects that Bill Melinda Gates Foundations Maternal, Newborn Child Health program performs to inflate coverage of high affect interventions to guarantee that women and infants stay alive and be healthy at the time of childbirth and further than that. This program invests in efforts to adjust and build up innovative tools, treatments and technologies. Additional to this they aim to improve the excellence of healthcare services and practices and the connections between health practitioners and relatives and advocate for nationwide and global policies that advantage maternal, child survival, newborn and health (Campbell et al., 2013). As stated by Timofeev et al. (2013), on the basis of a meta-analysis of three different studies carried out by a group of researchers, women living in poor hygiene surroundings are three times as probable to die from maternal physical condition related issues contrast to female who do not, while women existing under deprived water circumstances have a motherly mortality ratio fifty percent more than persons that do not. Partially the malnutrition cases universally can be accredited to poor water, hygiene and sanitation. As discussed by (Campbell et al. (2013), several of these deaths are consequences from vaccine avoidable diseases, since impediments like as cost and convenience has hindered efforts to distribute effective vaccines to individuals mainly in need. In addition, a lot of vaccines known to mothers and children below age five are not appropriate for infants, since their growing immune systems do not respond optimally throughout the primary few months of existence. Maternal immunization is the procedure by which an expectant womans immune structure is equipped with an exacting disease, and the shield is then transferred to her child expected to take birth. Moreover, strategies have emerged to avert many redundant maternal and baby deaths (Schoolcraft Katz-Jaffe, 2013). Older women have greater chances of children born with chromosomal aberration. One such major aberration is Down Syndrome. According to researches, it is observed that in 80% of the babies affected with Down syndrome are born to women above the age of 35. Susan a Hispanic woman of 37 years of age, who had a normal pregnancy. A screening test was done after a period of gestation of 16 weeks, which was normal and indicated a 1/275 probability of Down Syndrome. On the basis of this result, the prenatal diagnostic tests were not conducted. Additionally, ultrasonography examination showed no anomalies. Susan's family background reveals that the first cousin from her maternal side who is 12 years old is affected with Down Syndrome (Timofeev et al., 2013). During the birth of Susan's daughter showed probable features of Down Syndrome, such as Mongolian facial features and "floppy baby syndrome" that is reduced the strength of muscles. Susan shared her suspicion with her physician. Blood was collected to determine the chromosome number. It was confirmed, after a week, that the child was affected with Down Syndrome and the genotype of the child was (47, XX, +21). Clinical diagnosis of the mother -Examination of the maternal serum could help in the detection of maximum cases of Down Syndrome. In this case, the triple screening of Susan, which was obtained as 1/275, revealed higher chances of risk as compared to other risks related to her age which is 1/826. The results in her case were not considered as positive by the laboratory, but usually in such cases, the cut off for a positive test is determined as 1/200 (Roos-Hesselink et al., 2013). Clinical diagnosis of the neonate - Evaluation of a discrete set of issues is necessary for neonates with Down Syndrome- There are about a 50% of chance for the child to suffer from inherent heart disease.Vomiting is persistent in such children, and they also show symptoms of duodenal atresia or obstruction in the movement of bowel. They also suffer from hearing loss, visual disability, polycythemia and inherent hypothyroidism Assessment of risks - Postbirth of newborn with Down Syndrome it is a main concern which arises is the chances of reoccurrence of Down Syndrome in future pregnancies. However, in this case, there is a minimal risk for Susan and her partner since the disease is caused by nondisjunction of chromosome 21, but if the disease is caused due to translocation of the chromosome, the chances of occurrence increases. Since in this case Susan already had a relative affected by Down Syndrome, this though was treated as a critical case accounted for unbalanced translocation of chromosomes which depict inheritance (Timofeev et al. 2013). Probability in this case - Trisomy of chromosome 21 is noninherent and is infrequent in occurrence. Hence, Susan and her partner need not go through further examinations. In future, if Susan decides to have a child, the risk of having another case of Down Syndrome is approximately less than 1% and is completely unrelated to her cousin having the disease. However, since Susan age has exceeded 35, there remains a danger of having a child with chromosomal aberrations (Mhyre et al., 2014). In this context, the meaning and the implications of various strategies of maternal age has been discussed. Maternal age is defined the age of the mother during the time of delivery of the offspring. As stated by Timofeev et al. (2013), studies reveal those older women above thirty five years are more susceptible to risks associated with pregnancy than a younger woman. The global society is not yet so advanced and insufficiently galvanized in terms of addressing neonatal and maternal mortality. Certain areas in the healthcare sector and the government sector needs to be improved in order to reduce this complication. Cost and accessibility are the two major factors that affect child and mother mortality. According to researches, it is observed that in 80% of the babies affected with Down syndrome are born to women above the age of 35. Susan a Hispanic woman of 37 years of age, who had a normal pregnancy. During the birth of Susan's daughter showed probable features of Down Syndrome, s uch as Mongolian facial features and "floppy baby syndrome" that is reduced the strength of muscles. Susan shared her suspicion with her physician. Examination of the maternal serum could help in the detection of maximum cases of Down Syndrome. Evaluation of a discrete set of issues is necessary for neonates with Down Syndrome- There are about a 50% of chance for the child to suffer from inherent heart disease. Blood was collected to determine the chromosome number. It was confirmed, after a week, that the child was affected with Down Syndrome and the genotype of the child was (47, XX, +21). (Mhyre et al., 2014). The major causes of stillbirth vary by gestational age. Infection is the most common contributor of mortality. Huang and his colleagues reported that the outcome of a methodical appraisal of retrospective cohort and case organize studies of the link between advanced maternal age and the danger of stillbirth. The evidence reflects that Bill Melinda Gates Foundations Maternal, Newborn Child Health program performs to inflate coverage of high affect interventions to guarantee that women and infants stay alive and be healthy at the time of childbirth and further than that. Partially the malnutrition case universally can be accredited to poor water, hygiene and sanitation. Several of these deaths are consequences from vaccine avoidable diseases since impediments like as cost and convenience have hindered efforts to distribute effective vaccines to individuals mainly in need. Thus, it can be concluded that there are although major risks associated with advanced maternal health in terms o f the global scenario, this situation can be controlled by evidence-based practice and innovative policies and tools (Mhyre et al., 2014). References: Aldous, M. B., Edmonson, M. B. (1993). Maternal age at first childbirth and risk of low birth weight and preterm delivery in Washington State.Jama,270(21), 2574-2577. Bauer, M. E., Bateman, B. T., Bauer, S. T., Shanks, A. M., Mhyre, J. M. (2013). Maternal sepsis mortality and morbidity during hospitalization for delivery: temporal trends and independent associations for severe sepsis.Anesthesia Analgesia,117(4), 944-950. Benzies, K. M. (2008). Advanced maternal age: Are decisions about the timing of child-bearing a failure to understand the risks?.Canadian Medical Association Journal,178(2), 183-184. Campbell, K. H., Savitz, D., Werner, E. F., Pettker, C. M., Goffman, D., Chazotte, C., Lipkind, H. S. (2013). Maternal morbidity and risk of death at delivery hospitalization.Obstetrics Gynecology,122(3), 627-633. Carey, D. (2015). Pregnancy and advanced maternal age. Croen, L. A., Najjar, D. V., Fireman, B., Grether, J. K. (2007). Maternal and paternal age and risk of autism spectrum disorders.Archives of pediatrics adolescent medicine,161(4), 334-340. Davis, L. E., Lucas, M. J., Hankins, G. D., Roark, M. L., Cunningham, F. G. (1989). Thyrotoxicosis complicating pregnancy.American journal of obstetrics and gynecology,160(1), 63-70. Dong, M., Zheng, Q., Ford, S. P., Nathanielsz, P. W., Ren, J. (2013). Maternal obesity, lipotoxicity and cardiovascular diseases in offspring.Journal of molecular and cellular cardiology,55, 111-116. Donofrio, M. T., Moon-Grady, A. J., Hornberger, L. K., Copel, J. A., Sklansky, M. S., Abuhamad, A., ... Lacey, S. (2014). Diagnosis and treatment of fetal cardiac disease a scientific statement from the American Heart Association.Circulation,129(21), 2183-2242. Fisk, N. M., Atun, R. (2008). Market failure and the poverty of new drugs in maternal health.PLoS Med,5(1), e22. Huisman, C. M., Zwart, J. J., Roos-Hesselink, J. W., Duvekot, J. J., van Roosmalen, J. (2013). Incidence and predictors of maternal cardiovascular mortality and severe morbidity in The Netherlands: a prospective cohort study.PLoS One,8(2), e56494. Jacobsson, B., Ladfors, L., Milsom, I. (2004). Advanced maternal age and adverse perinatal outcome.Obstetrics Gynecology,104(4), 727-733. Kahraman, S., Bahce, M., Ã…Å ¾amlÄ ±, H., Ä °mirzalÄ ±oÄÅ ¸lu, N., YakÄ ±sn, K., Cengiz, G., Dnmez, E. (2000). Healthy births and ongoing pregnancies obtained by preimplantation genetic diagnosis in patients with advanced maternal age and recurrent implantation failure.Human Reproduction,15(9), 2003-2007. Mhyre, J. M., Tsen, L. C., Einav, S., Kuklina, E. V., Leffert, L. R., Bateman, B. T. (2014). Cardiac arrest during hospitalization for delivery in the United States, 19982011.The Journal of the American Society of Anesthesiologists,120(4), 810-818. Pearson, G. D., Veille, J. C., Rahimtoola, S., Hsia, J., Oakley, C. M., Hosenpud, J. D., ... Baughman, K. L. (2000). Peripartum cardiomyopathy: national heart, lung, and blood institute and office of rare diseases (national institutes of health) workshop recommendations and review.Jama,283(9), 1183-1188. Roos-Hesselink, J. W., Ruys, T. P., Stein, J. I., Thiln, U., Webb, G. D., Niwa, K., ... Tavazzi, L. (2013). Outcome of pregnancy in patients with structural or ischaemic heart disease: results of a registry of the European Society of Cardiology.European heart journal,34(9), 657-665. Schoolcraft, W. B., Katz-Jaffe, M. G. (2013). Comprehensive chromosome screening of trophectoderm with vitrification facilitates elective single-embryo transfer for infertile women with advanced maternal age.Fertility and sterility,100(3), 615-619. Sliwa, K., Anthony, J., Hilfikerà ¢Ã¢â€š ¬Ã‚ Kleiner, D. (2016). Maternal heart health.The Heart of Africa: Clinical profile of an evolving burden of heart disease in Africa, 9-26. Timofeev, J., Reddy, U. M., Huang, C. C., Driggers, R. W., Landy, H. J., Laughon, S. K. (2013). Obstetric complications, neonatal morbidity, and indications for cesarean delivery by maternal age.Obstetrics and gynecology,122(6), 1184. Wanderer, J. P., Leffert, L. R., Mhyre, J. M., Kuklina, E. V., Callaghan, W. M., Bateman, B. T. (2013). Epidemiology of Obstetric-Related Intensive Care Unit Admissions in Maryland: 19992008.Critical care medicine,41(8), 1844.

Monday, December 2, 2019

The Spanish Civil War free essay sample

This research paper is about the significance of the Spanish Civil War to early 20th century world-history. The paper discusses the Spanish Civil War in detail (including its background) and analyzes how General Francos push for fascism in Spain proved to be the precursor of the Second World War. The paper includes a brief discussion of the different ideologies that were at play in the conflict. It also explores the reasons behind the defeat of the Republicans despite their apparently just cause against the Nationalists. The Spanish Civil War that started in 1936 following the failure of a military rebellion under the leadership of General Francisco Franco (1892-1975) to overthrow the democratically elected Republican government of Spain, lasted for three years. The Civil War still evokes passionate debate among historians and political analysts around the world. The war was a bloody affair that took a heavy toll of human lives, estimated at 500,000. We will write a custom essay sample on The Spanish Civil War or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page This still does not explain the interest and extreme passions that the Spanish Civil War evoked at the time (and continues to do so more than 60 years after its end) around the world. The reason for the interest in a war that, in normal circumstances, would have been dismissed as an internal conflict for supremacy in a has-been European power, is the timing of the event that occurred at a fluid time in world history when several political ideologies were in a melting pot. These ideologies consisted of the whole range of the political spectrum from the extreme right to the extreme left. The Anarchists, the Socialists, the Fascists, the Syndicalists, the Monarchists, the Roman Catholics, the Communists (including the Stalinists and the Trotskyites) all had their say in the war. No wonder then that the Spanish Civil War, instead of being relegated in history as a footnote to the Second World War that immediately followed it, is considered to be a major event in its own right and is st udied, discussed and analyzed at great length even today.