Monday, April 20, 2020

Reasons why readmission of CHF patients is high in local setting

Abstract CHF is a health condition that affects normal operations of the body of a human person by interfering with the supply of blood to other body parts leading to the impairment of their normal functioning. The condition affects many people in different countries throughout the world. The U.S. is one of the developed countries that are affected by the CHF patients. It is estimated that about 5.3 million Americans suffer from this condition.Advertising We will write a custom essay sample on Reasons why readmission of CHF patients is high in local setting specifically for you for only $16.05 $11/page Learn More Due to the critical nature of the condition and other factors, this study seeks to establish reasons for increased number of CHF patient readmission in a local setting (Nasif Alahmad, n.d.). Using the quantitative research method, the study will examine readmission patients in a local hospital that has a 300-bed capacity. From the study finding s, CHF patient readmissions are caused by various factors such as non-compliance to medication, smoking, drinking alcohol and lack of diet modification (Pitt, et al. 2000). Introduction Chronic Heart Failure is a medical condition in which the heart of an individual is unable to pump enough blood to other parts of the body in order to enable them function as required. The condition is serious and could lead to other medical complications affecting patients if the condition is not detected and treated early. CHF condition is prevalent in all countries throughout the world. Using quantitative research method, this study examines reasons for the readmission of CHF patients in the local setting. Some of the established reasons for CHF patient readmissions were smoking, medical noncompliance, dietary changes and drinking (Brophy, et at. 2001). Problem Statement CHF is an issue affecting many people and public health systems in different countries across the world. More than 20 million pe ople worldwide are affected by CHF while 2% of prevalent patients are reported in developed countries. Nasi Alahmad (n.d.) note that the American Heart Association has reported that there are 5.3 million Americans suffering from the CHF condition with 660,000 new patients being reported annually. The occurrence of the condition is about 10 people per 1000 persons in the U.S. population. Due to health implications brought about by the CHF condition, about 287,000 people die every year. In spite of increased infection rates of CHF, the success rate of treating the conditions has also increased (Georgiou, et al. 2001). On the contrary, the problem remains high in rural settings that are characterized by high readmissions of CHF patients. Therefore, this study investigates reasons for high CHF patient readmission in a local setting (Jong, et al. 2002).Advertising Looking for essay on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn Mor e Literature Review The condition affects both individuals and the economy. The public health sector is forced to spent large amounts of money on the treatment of CHF patients every year. According to Nasif Alahmad (n.d.), the U.S. spent about $34.8 billion in 2009 whose large part went to hospital readmissions. The centers for Disease control and prevention indicate that African American population in the U.S. contracts CHF at the rate of 70% compared to other population groups that have lower levels. In addition, many of the reported patients involve individuals aged between 45 and 65 (Centers for Disease Control and Prevention, 2004). Short breaths characterize the CHF condition with early symptoms being exertion. Dyspnea, the sudden development of severe short breaths at night that awaken patients is experienced by CHF patients as the condition progresses to the critical situation over time (Hernandez, et al. 2007). According to Yancy (2004), pulmonary congestion is one of th e related conditions to other initial symptoms of the disease. The pulmonary congestion occurs due to the interstitial and alveolar spaces that are caused by pulmonary edema. The two common conditions of CHF are the systolic heart failure and diastolic heart failure that is characterized by impaired relaxation phase of the cardiac muscle. McKelvie et al. (1995) note that the coronary artery disease, stroke and the peripheral artery disease that form the risk factors for contracting the disease contribute to the development of CHF disease during the mature stages of the disease that when not treated early, may cause death. Following the occurrence of the disease, rural settings have been reported to have increased rates of readmissions for patients with the CHF condition. The high readmission rates of the disease in these areas is attributed to many factors some of which include patients not complying to medication, lack of modification of the diet, intake of alcohol, smoking and lac k of community follow up (Elixhauser, et al. 2000). Methodology A research can be either quantitative or qualitative in nature depending on the research method undertaken by the researcher. This study employed a quantitative research method with a quantitative research design that involved the researcher collecting numerical data using quantitative data collection tools such structured questionnaires (Quinn, 2002). The researcher used purposive sampling technique to select a sample comprising of 65 and above year old patients suffering from CHF condition from a large population of CHF patients in a local setting. The researcher did not group the sampled population any further based on other factors such as race, color, ethnicity or point of origin in order to ensure validity and reliability of the study. The variables for the study included readmission that is the dependent variable while independent variables were many and included factors such as non-compliance to medication, smok ing, drinking alcohol and lack of diet modification (Saunders, Lewis Thornhill, 2007).Advertising We will write a custom essay sample on Reasons why readmission of CHF patients is high in local setting specifically for you for only $16.05 $11/page Learn More Findings The findings of the study indicate that the level of CHF patients in the rural setting fluctuated over the period from January 2010 to March 2011. The patients were as high as 17 in January 2010 (Piepoli, et al. 2004). They declined to a low level of 5 patients during the month of May 2010 before beginning to increase gradually to 16 patients during the month of March 2011 as indicated in the figure below. The increase in the level of CHF readmissions was attributed to be various factors such as non-compliance to medication, smoking, drinking alcohol and lack of diet modification as illustrated and explained below. January 2010 From the figure below, it is revealed that the cause of readmi ssions for CHF patients was all the factors listed above. However, the composition differed. It is clear that the highest cause of CHF patient readmissions was lack of community support while the lowest causes for CHF patient readmissions were smoking and lack of diet modifications. February 2010 The month of February 2010 saw some decrease in the total number of CHF patients readmitted to the hospital with the total number declining by 5 CHF patients. The causes remained the same with different compositions. Lack of community support remained the main cause of CHF patients’ readmissions with increased number of CHF patients being readmitted. Smoking led to increased patient readmissions from 3 patients in the month of January to 5 patients in the month of Feruary. The lowest cause for CHF patient readmission was lack of dietary modifications. March 2010 This month was a different in the hospital because there were changes in the composition of causes for CHF patient readmiss ions. Total patients readmissions reduced to 9 patients. However, the main cause of readmissions was lack of dietary modifications that had the rate of 6 patients being readmitted while the lowest reason for patients being readmitted was smoking. April 2010 This period saw the increase in the number of CHF patient readmissions to 10 patients from 9 in the previous month. The highest cause of patient readmission for this period was smoking that had the rate of 7 patients being readmitted followed by lack of community support. However, the lowest causes remained lack of dietary modifications followed by lack of follow up on PCP as illustrated below.Advertising Looking for essay on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More May 2010 This period saw a decline in CHF patient readmission to 7 patients. The causes remained the same while the highest cause was lack of dietary modifications at the rate of 6 patients followed by medication non-compliance. On the contrary, the lowest cause of CHF patient readmission during this month was smoking at the rate of 2 patients. June 2010 During this period, CHF patient readmissions in the local hospital increased to 15 patients. The increase in the number of readmissions can be attributed to the increase in the number of readmissions caused by lack of dietary modifications. This factor increased the number of readmissions from 6 to 8. The next causes of readmission were medication noncompliance. On the contrary, the lowest cause of CHF patient readmission in the month as the smoking that had the rate of 2 patients. July 2010 Readmissions in the course of this month dropped by 2 patients to remain at 13 patients. The cause of the drop in patient readmission was lack of dietary modifications followed by medical non-compliance (Smedley, Stith Nelson, 2003). The rest of the causes remained at the rate of 2 patients as illustrated below. August 2010 CHF patient readmission increased to 14 patients following the increase in the number of patients that were readmitted due to non-medication compliance that was the highest cause of readmission. The factor led to an increase in patient readmission from 3 patients to 7 patients. Similarly, lack of dietary modifications was responsible for 7 readmitted patients hence being another highest reason for patient readmission. On the lower side, other causative factors remained low at the rate of 2 patients except for lack of community support that led to three patients being readmitted. September 2010 During this period, readmitted patients increased to 16 following an increase in the patients caused by all other factors except medical non-compliance and lack of dietary modifications (Wang, et al. 2003). Howev er, the highest causative agents were medical noncompliance and lack of dietary modifications. October and November 2010 December 2010 and January 2011 February and March 2011 Conclusion From the findings of the study, it is evident that readmission patients in the rural setting fluctuated over the period of study. The reasons for readmissions of CHF patients were non-compliance to medication, smoking, drinking alcohol and lack of diet modification. Others were lack of follow up to PCP and lack of community support. The highest causative factors for CHF patient readmissions were medical non-compliance, lack of dietary modifications and lack of community support. On the contrary, the lowest causative factors of CHF readmissions were lack of follow up on PCP and alcohol intake. The months of January 2010, September 2010 and March 2011 recorded the highest CHF patient readmissions while the lowest rates of patient readmissions were recorded during the months of May 2010, March 2010 and April 2010. It is therefore evident that the rates of CHF readmission patients in the rural setting are high with causative factors being as indicated above. References Brophy, J.M.e at. (2001). Beta-blockers in congestive heart failure. A Bayesian meta-analysis. Ann Intern Med, 134(550), 135-151. Centers for Disease Control and Prevention, (2004). The Burden of Heart Disease and Stroke in the United States: State and National Data, 1999. Atlanta: Centers for Disease Control and Prevention. Elixhauser, A, et al. (2000). Table 4. Most Common reasons for hospitalizations by age groups, in Hospitalization in the United States, 1997, Rockville Agency for Healthcare Research and Quality, HCUP Fact Book. New York: AHRQ publication. Georgiou, D. et al. (2001). Cost-effectiveness analysis of long-term moderate exercise training in chronic heart failure. Am J Cardiol, 87, 984. Hernandez, A.F. et al. (2007). Sex and racial differences in the use of implantable cardioverter-defibrillators amo ng patients hospitalized with heart failure. JAMA, 298,1525-1532. Jong, P. et al. (2002). Angiotensin receptor blockers in heart failure: Meta-analysis of randomized controlled trials. Journal of Am Coll. Cardiol, 39, 463. McKelvie, R.S. et al. (1995). Effects of exercise training in patients with congestive heart failure: A critical appraisal. J Am Coll Cardiol, 25:789. Nasif, M. Alahmad, A. (n.d.). Congestive Heart Failure and Public Health. Piepoli, M.F. et al. (2004). Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). BMJ, 328, 189. Pitt, B. et al. (2000). Effect of losartan compared with captopril on mortality in patients with symptomatic heart failure: randomised trial–the Losartan Heart Failure Survival Study, Lancet: ELITE II. 355:1582. Quinn, M. (2002). Qualitative Research Evaluation Methods, 3 Ed. Thousand Oaks, NJ: Sage Publications. Saunders, M., Lewis, P. Thornhill, A. (2007). Research Methods for Business Studies. Fourth Edition. Boston, MA: Pearson Education. Smedley, B.D., Stith, A.Y. Nelson, A.R. (2003). Unequal Treatment: confronting racial and ethnic disparities in healthcare. Institute of Medicine, National Academy of Sciences. p. 43–4. Wang, T. et al. (2003). Natural history of asymptomatic left ventricular systolic dysfunction in the community. Circulation, 108, 977–982. Yancy, C. (2004). The prevention of heart failure in minority communities and discrepancies in health care delivery systems. Clin N Am, 88, 1347–1368 This essay on Reasons why readmission of CHF patients is high in local setting was written and submitted by user William Bartlett to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Sunday, March 15, 2020

Segnaletica e arredo nel design dellospitalitagrave;

Segnaletica e arredo nel design dellospitalitagrave; SEGNALETICA E ARREDOElena TurazziniPOLITECNICO DI MILANOFACOLTA' di DISEGNO INDUSTRIALE A.A. 2002-2003Molto di quello che si dice e si scrive ÂÆ' inquinamento. (Marshall McLuhan)SEGNALETICA: serve a segnalare, a far riconoscere, ad informareSEGNALE: segno convenzionale per indicare o far conoscere qualcosaINDICARE: far vedere o far capire con cenni, parole o segnalisuggerire, consigliare, prescrivere, rivelare, lasciare intendere, manifestareLa segnaletica come comunicazione e orientamento ha bisogno di un'efficiente organizzazione e progettazione;richiede di coniugare cempetenze tra loro diverse: bisogna tenere conto delle nuove tecnologie, delleconvenzioni, della progettazione grafica, di sociologia e psicologia. Deve informare (letteralmente significa"formare" , dare una forma a qualcosa di nuovo, che seppure esistente, non ? ancora stato definito).in grado di facilitare agli utenti un pronto e sicuro orientamento, e perch? no, anche un miglioramento estetico.esigenze di leggibil it , di durata, di intercambiabilit e di design, di modularit , flessibilit , robustezza eantimanomissioneUn sistema comprende segnavia principali e intermedi, segnaletica di sicurezza, di avvertimento, di divietoe di emergenza, in particolare si possono elencare: posatavoli, moduli informativi su piedistallo, targhe aporta e a muro, pittogrammi, ecc.Extraordinary Canadians: Marshall McLuhanMolte ditte producono sistemi di segnaletica completi per esterni e per interni che rispondono a qualsiasiesigenza, con un ampio assortimento di segnali standard, studiati appositamente per alberghi, hotels e centricongressi. Sono realizzati in alluminio, con finitura oro o argento a specchio e nei colori standard di verniciatura,nel classico "in stile" tipico degli alberghi, a imitazione di quello del grande albergo internazionale dei primidel XX secolo.Alcuni tipi di alberghi invece, come i design hotels, creano su misura la propria segnaletica. In un primomomento perch? la ricerca estetica dei prodotti in commercio non corrisponde con l'attuale ricerca del design,(ma come detto prima...

Friday, February 28, 2020

DID THE US OR SOVIET UNION CAUSE THE 1962 CUBAN MISSILE CRISIS Essay

DID THE US OR SOVIET UNION CAUSE THE 1962 CUBAN MISSILE CRISIS - Essay Example Germination of political conflict between these two nations commenced since very aftermath the World War II. During the Second World War, United States and Soviet Union, mutually, played leading role in putting an end to the terror and devastation of the Third Reich. However, end of the War helped them to evolve as two superpowers, capable of dominating the entire global politics. While the United States emerged as a titan among Western nations, the Soviet Union became its Eastern answer1. The conflict of power became inevitable as both nations were trying to prove their respective supremacy and rather than providing priority to the development of international political situation, they took further interest in opposing each other’s policies.2 The conflict between United States and Soviet Union also commenced on a different ground that is their respective ideology towards socio-cultural and socio-economic aspects. While capitalism dominated the ways of American approach towards determining the nature of socio-political factors, socialist approach was adopted by the Soviet Union to earn support of nations in their favor. During the post World War II period, United States not only made aggressive attempts to receive control over political and economic affairs in the international context, consequently, with an intention to reduce power and support of the Soviet Union, it tried to point out the flaws in the socialism that Soviet Union was trying to assert. Soviet Union, on the other hand, also vehemently criticized American tendency of economic imperialism and attempted to assert that socialism is the only way to survive the grasp of American capitalist aggression.3 Result of such attacking and counter attacking became more evident as the entire domain of international politics was divided into two specific groups: â€Å"On one side were the

Tuesday, February 11, 2020

Chapter 12 Assignment Example | Topics and Well Written Essays - 500 words

Chapter 12 - Assignment Example Cateora, Gilly, & Graham (2011) explore some of the reasons that can make a country not to be farther considered as a potential market via a planning process. The planning process is divided in to four phases but this paper will explore how and why a country can be dropped in the first two phases. The objective of the first phase is to match the needs of the company and its home country to those of the host country. The compatibility of the company’s character and its home country to those of the host country is the basis on which countries are either disqualified or qualified as markets. The first thing that a business will look at when evaluating a host country is the economy of that particular country. Every business wants to be associated and to partner with a country that records substantial economic growth or has a stable economy. For example, Greece can be viewed as a potential market for commodities like electronics. However, the fact that Greece’s economy is experiencing major debt problems would disqualify it from being a potential market. The second most important criterion that is used to evaluate a potential market is the political stability and the legal policies of the host nation. The political stability is very key if a potential market is to be considered as an actual market. This is because it ensures the safety of the business and its personnel and in most cases, it also means that the legal policies are favorable for running a business. The legal policies may include taxation brackets and the political stand of the country on trade regulating policies. Competition is the third criterion as highlighted by

Friday, January 31, 2020

The In-between world of Vikram Lall-Draft Essay Example for Free

The In-between world of Vikram Lall-Draft Essay Home is an anchor; without it, one is lost. Brainstorming: The story is itself of an Asian living in an alien land of Africa which since centuries has been a colony of British regime. This essay will be developed around the Vikram Lal’s life in the alien land, and how he landed in Canada. Vassanji’s power lies in his carefully narrated skill in examining the paradoxical and complex situations in which Lal Ji and many other Asians find themselves. It is all an issue of bringing forth hidden identity in the soils where racism and class division is at its peak and always struggling to make themselves feel at home in the alien land away from home. It is rightly said that Home is an anchor; without it, one is lost. It implies that Home makes us realize what we are and who we are. It makes us identify with ourself, with neighbors and society. In an alien land more and more we try to search our identity more and more we find ourselves lost in the two worlds. In the quest to be loyal to the alien land we deprive ourselves from our own identity and if we refuse to adopt the alien world, we are not adopted by that world. I would try to explore how Vassanji’s tried to explore this dilemma in the minds of the immigrants through the story of Vikram Lal in the family. Outline Racism Author was himself born in Kenya It is his own experiences which are reflected in the book Through the voice of Vikram Lal, this story will bring about the problem of citizenship for the people of Asian Descent in Kenya and how they are adjusting and adopting themselves in the alien land where Kenya is itself engulfed in the fire of rebellion against the British regime. The situation of Kenya when it is rapidly descended into neo-colonialism addresses the issue of citizenship for people of Asian descent in Kenya by studying the during the president-ship of Jomo Kenyatta. Rough Draft Racism was deeply into the   soils of Kenya and the Aisans too had to face the burnt of racism and the question of class further raised the question of establishing him politically. The way Vikram Lall perforrn his struggle for citizenship is in sharp contrast to his friend Nioroge who inspite of belonging to the very lowest strata of society, he occupied highest posistion duing neocolonial period.   was occupieng the   considered to be   differentiated

Thursday, January 23, 2020

Free Siddhartha Essays: Themes in Siddhartha :: Hesse Siddhartha Essays

Themes in Siddhartha Siddhartha by Hermann Hesse tells of a man, Siddhartha, and his search for peace.   Siddhartha leaves the Brahmins to become a holy Samamna.   He finds no satisfaction in the deprivation, which the Samanas practice, so he leaves their way of life to find the Buddha.   The Buddha's teachings fail to satisfy his desire to find a path to peace, also.   He then travels to a town but finds no answers there either.   Finally, beside the river, Siddhartha finds peace.   There are two main themes in Siddhartha; the father/son theme and the theme of peace and totality.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The theme of father and own can be found at the beginning and end of the novel.   Siddhartha leaves his father at the very beginning of the book in order to find the peace he feels he has not achieved by being a Brahmin, and Siddhartha never sees his father again.   Siddhartha has a son with a courtesan in the town and has responsibility for him after his mother dies; the boy does not like staying by the river with Siddhartha and runs away, causing Siddhartha the same grief that Siddhartha had caused his own father years ago.   These losses suffered by the by both Siddhartha and his father are all a part of Siddhartha's journey to achieve inner peace.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The theme of peace and totality appears throughout the Siddhartha.   Siddhartha's father performs ablutions in the river and offers sacrifices to the gods in a never ending attempt to achieve peace within himself.   The Samanas practice deprivation and attempt to escape the Self through meditation, only to realize that they only achieve totality for a short time.   The Buddha has found peace and vainly attempts to explain to others how they, too, might achieve peace.

Tuesday, January 7, 2020

Essay about Advantages and Disadvantages of Free...

1a) Advantages of free international trade 1. Increasing the production. Countries are enabled by free international trade to specialise or to focus in the production of the goods in which they have a comparative advantage. Specialisation countries can take the benefit of efficiencies generated from increased output and economies of trade. The size of the firm’s market are increased by the international trade which results in lower average costs and increasing in productivity, as it ultimately leads to increase in production. 2. Production efficiencies. The efficiency of resources allocation is improved by the free international trade, as the higher productivity and increasing in total domestic output of commodities and services are†¦show more content†¦With free international trade a lot of jobs will be created in the country, especially in industries of manufacturing and services which can absorb the unemployment that created by restructuring as firms down their workforce. Disadvantages of free international trade. 1. Structural unemployment may occur in the short term with the removal of trade barriers. This will have impact on large numbers of workers, as well as their families and local economies. In growth industries workers often will have difficulties to find employment. 2. Business, consumers and employees are more weak to downturns in the economies of trading partners. For example, recession in the USA leads to decrease in demand for UK’s exports, leading to falling in export incomes, lower GDP and incomes, decrease in domestic demand and rising in unemployment. 3. Some of the countries with surplus commodities may dumb them on international markets at a low price. Under such conditions, some of the efficient industries can might find difficulties in competing for long period. Furthermore, countries whose economies are mostly rural will face unfavourable terms of trade. For example, ration of export prices to import prices. 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