Discuss the nature of management, financing, and quality issues related to integration and cooperation in the facilities

/in /by

Discuss the nature of management, financing, and quality issues related to integration and cooperation in the facilities.

Choose two long-term care facilities—one from nursing facilities, assisted living, or subacute care and another from adult day care, home health care, or hospice care—on which you would want to base your research work. Research Internet to read about your chosen long-term care facilities.

Assume you are responsible for the management and administration of the two facilities. You have to orient the newly appointed manager by providing an overview on managing long-term care. You also need to discuss the programs of the two facilities. From this perspective and based on your research about the facilities, prepare a Microsoft PowerPoint presentation of 10–15 slides including the following:

What are the various multidisciplinary departments (teams) included in your facilities?

Who comprise the target population being served by the various programs provided by your chosen facilities?

What are the major staffing and human resource issues faced by your chosen facilities?

What are the significant trends in long-term care likely to impact the operation of the various programs provided by your chosen facilities, and what is your plan of action to overcome them?

What are the various forms of cooperation and integration existing in your chosen facilities? Discuss the nature of management, financing, and quality issues related to integration and cooperation in the facilities?

localization global standardization transnational strategy

/in /by

Please answer the following questions:

In what kind of industries does a localization strategy make sense? Why? When does a global standardization strategy make the most sense? Why?

What do you see as the main organizational problems that are likely to be associated with the implementation of a transnational strategy? Explain.

What is the most appropriate organizational architecture for a firm that is competing in an industry where a global strategy is most appropriate?

Discuss the differences between preventive and corrective discipline.

/in /by

Discuss the differences between preventive and corrective discipline.

Paper instructions:
1. Discuss the differences between preventive and corrective discipline. Do you favour one form of discipline over the other? Identify the contexts in which each is most appropriate.

2. Explain the difference between “equal pay for equal work” and “equal pay for work of equal value,” and elucidate the differences in implications for a human resources manager.

These two questions needs to be answered. Page and a half for each question. This is regarding human resources management in health care organization.

Health Essays – Childhood Obesity Overweight

/in /by

Childhood Obesity Overweight

Introduction

Childhood obesity in the United States is proving to be a topic of major concern. Throughout the past decades, this issue has been overlooked and simply unattended to. Other health issues such as second-hand smoke and cancer have indeed been the more popular topics addressed. However, people are starting to notice a change in the leaders of tomorrow. Quite frankly, these children are becoming extremely unhealthy and overweight. In the past, it was out of the ordinary to see a child that was obese.

However, overweight children in the United States are actually starting to become a norm (Koplan, Liverman & Kraak, 2005). This is where the problem begins to unfold. Parents are becoming increasingly concerned about their children’s health due to the fact that obesity hinders a wide range of factors. Imagine a child that cannot participate in any extracurricular activities such as baseball, soccer, or basketball due to his or her weight.

Then, try to explain to that child that due to being overweight, he or she might have an increased chance of heart disease, strokes, and high blood pressure (Vessey & MacKenzie, 2000). Above all, imagine being a child and learning that one of their peers has just died due to the fact that he or she was obese. One must begin to realize that the lives of children in the United States are at stake.

Science in the past has told the public that each generation is living longer than its precedent. The tide has turned sadly enough as scientists are predicting that this verity is now untrue (Kimm & Obarzanek, 2002). With that being said, if lives are beginning to shorten, one might conclude that it is now time to take some action.

In an attempt to explore the idea of childhood obesity one must result to an interdisciplinary analysis. The topic involves a wide range of disciplines such as biology, sociology, psychology, and business, which should all be taken into consideration to avoid an oversimplification. There is not one single discipline that can fully address the entire scope of childhood obesity (Repko, 2005). By narrowing down the research, a large amount of data will be looked at using numerous perspectives to try to avoid a biased outcome.

The extent of obesity in children is an extremely multifaceted topic and desperately needs to be approached this way to fully grasp and comprehend the issue. Also, for a complete understanding and resolution to be formulated, every discipline needed to investigate the issue must be used. Childhood obesity contains a vast range of disciplines to help in its characterization. With that being said, these disciplines tend to all be interlocked with one another.

Looking at childhood obesity through the discipline of biology for instance would constantly be leading the researcher to a psychological standpoint every time a page is turned. Simply ignoring certain disciplines would be an extreme mistake in trying to come to a conclusive solution of the issue addressed and would most likely lead to a biased opinion.

Disciplines

The following is a compilation of all the disciplines used along with each of their contributions in the process of addressing the issue of childhood obesity. There is indeed a vast range of disciplines that are included. Chemistry, economics, law, and history all bring important insights to the table when addressing childhood obesity. Chemistry will look at various experimental data to try to assess the various structures of fats and sugars that are involved in a child’s diet.

Economics could be used to try to understand the possible effects that production and distribution of certain foods has when placed in front of children. Why are these extremely unhealthy foods being put on the shelf for kids to buy? Economics would try to investigate this issue and bring forth a decisive explanation. In addition, law would be utilized to help to understand what governmental efforts have been made towards the issue of childhood obesity.

Are the steps being taken by are government in the right direction or are they simply dancing around the heart of the issue? Finally, history is a very helpful discipline in referencing statistical data taken about obese children. Has this problem always been around or is it just now becoming an issue? History with the help of statistics will also illustrate past successes and failures of strategies that were put in action to help to aid the issue being discussed.

Throughout the course of the investigation of childhood obesity all the preceding disciplines listed will be taken into consideration. However, biology, sociology, and business will be most relevant and crucial to the process of defining the issue at hand.

Biology

Biology will be used to try to understand the needs of the human body to progress and function. Each person has a minimum amount of calories that must be consumed to properly run its processes. Likewise, each person has a unique rate of consuming these calories and converting them to energy. The researcher can use biology to place an actually measurement of health of an individual.

Attaining a proper measurement or gauge of health has proven to be a very difficult task. Height, sex, genetics, bone structure, and even ethnicity are all very important factors that determine a child’s proper weight. Biology will help to place a gauge on each of these factors and formulate a proper medium for each person. This discipline will be examined first in the following writing because one needs to understand what obesity is before he or she can begin to examine the problem. Biology will basically lay a foundation for the rest of the disciplines as to how they are to be used to assess obesity in children.

Sociology

Next, a viewpoint based on sociology must be addressed. Demographics of families, along with their ethnicities will be looked at to try to explain the effects of obesity on certain specific populations. Society will be investigated to try to expose the viewpoints of obese children and their parents. Does society really understand the issue? Do children place any concern with health and fitness? These are both very important questions that sociology will help to address through the aid of statistical data.

Also, every child does have the right to choose what he or she consumes on a day-to-day basis. Hence, each child must face all of the problems that arise if he or she becomes obese. Obesity is not purely a biological problem. If the previous statement was true, a child could then simply consume less calories and loose weight. However, a child has to make cognitive choices and observations about what is acceptable.

Sociology will step in and try to uncover any problems that may be resulting in a population of obese children that simply are misguided by the viewpoints of society. This discipline will be used after biology in hopes to build upon the new understanding of the problem. Once a person understands the physical aspects of childhood obesity using biology, then he or she can delve into the societal traits.

Business

Finally, obesity has become such a large issue that it has effectively created an entire new industry to take care of itself. Business is a discipline that will be used to help explain the way industries portray children and how they affect what populations recognize and understand. Business will try to assess ethical issues as to whether the food industry for example is making an effort to help.

There are obviously many businesses in the United States that are trying to educate children about obesity. However, for every positive product formed, there is another marketing scheme that is made to try to take advantage of a very helpless situation. As a result, the structure and function of the food industry needs to be addressed and scanned for possible pitfalls and shortcomings.

Lastly, the discipline of business will be used in the final part of this paper in hopes to illustrate how it relates back to the obese children. The reader will then furthermore understand the extremity of this issue and how it is rooted in almost every aspect of life.

In summation, childhood obesity is an extremely sophisticated problem involving the ethics and morals or our society. Children cannot be expected to solve their own problem and desperately need help from all ends of the spectrum. The purpose of this paper is to lay the foundation for a better understanding and new perspective of childhood obesity.

This perspective will hopefully stem new possible outcomes that are constructed by the synthesis of each of the discipline’s contributions. Furthermore, the following writing will attempt to educate society of the dangers of childhood obesity and show that this is not a problem caused by one situation. Hopefully the reader will realize that through an interdisciplinary understanding, bringing an end to obesity in children is not an unattainable goal.

Background

How is childhood obesity defined? Has this issue been around for a long time or is it merely just beginning to cause trouble for the United States? These are two very important questions that every individual needs to be aware of. One cannot expect to be able to successfully tackle an issue without knowing its history beforehand.

First, childhood obesity is basically defined as a person that has a body mass index that is above the 95

th

percentile. That is, the individual exceeds his or her natural weight by approximately 20%. Body mass index is the most widely accepted procedure for sampling obesity in large populations.

Basically, it is a numerical measurement composed of a person’s height and weight. Although this particular test does not take a persons bone structure into consideration, the average of an overall population remains very accurate (Vessey & MacKenzie, 2000).

The people involved in this issue are individuals between the ages of 6 and 17. Male and female children including every ethnicity that resides in the United States are included in this problem. Although obesity rates are increasing almost exponentially in all age groups, children seem to be of the most concern to health experts today. These children are in the most important stage of their growth. An overweight child is putting his or her entire lifespan in jeopardy (Green & Reese, 2006).

Adolescent obesity has not been around as long as other problems such as cancer, leukemia, or the flu. Yet, it is unique due to the fact that childhood obesity is growing at such an alarming rate. The first signs of childhood obesity began to appear in the 1960’s (Schwartz & Puhl, 2003). What caused this sudden weight gain in children during this time? There are several possible explanations however there does not seem to be one clearly defined culprit.

The fast food industry is just one of the possible causes that is often looked at. Critics believe that during the 1960’s fast food was starting to embed in American culture. McDonalds restaurants were popping up all around the United States offering a quick and effortless meal. Before fast food, most families were dependant upon time consuming home cooked meals. However, for the first time, people were starting to realize that a ready-to-eat meal was just a few dollars away. Consequently, people started putting the healthy meal aside and began to grab a quick sandwich from a fast food restaurant.

Hence, in the 1960’s children’s calorie intake began to rise as their eating habits were basically being altered by society. Statistics showed during this time that the percentage of obese children was approximately 4.5%. As calorie intake began to rise, physical activities began to decrease. Approximately 33% of students in high school do not expose themselves to any strenuous physical activity.

Present day schools are so involved in standardized testing that extracurricular activities have been in some ways taken out of the daily lesson plan. Even technology, which usually always aids in the advancement of society, has played a role in increasing rates of childhood obesity. Computer based games, and highly sophisticated cell phones are a few examples that have placed negative outcomes on beneficial cardiovascular events (Harper, 2006).

Heath experts began to see a problem by the 1970’s. The National Health and Nutrition Examination Survey was one of the first efforts in addressing the issue of childhood obesity. A study was done in three parts during a 25-year span starting in the late 1960’s. The test studied the body mass index of children and adjusted the results as age, sex, and ethnicity of the population of children changed through time.

The results were anything but subtle. There was a 40% increase of overweight children in the ten-year span of the first and second studies. No other illness at this time was even close to growing at such an astounding rate (Rosenbaum & Leibel, 1998). With that being said, the third study that was completed in 1994 delivered a divesting knockout punch. The National Health and Nutrition Survey revealed that the number of obese children in the United States had grown a monstrous 100% in the past 10 years (Dietz & Gortmaker, 2001).

Obesity in children was now considered an epidemic. In the past decade, the percentage of obese adolescents in the 95

th

percentile has once again doubled. Obese children between the ages of 6 and 11 seemed to have the highest grow rates of any other subgroup. Estimates were now showing that almost 15% of the children in the United States are obese or extremely overweight. Obesity does not seem to be biased towards any particular age, race, or gender. However, African American girls, Hispanics, and American Indians were shown to have the largest overweight populations (Koplan, Liverman & Kraak, 2005).

Why are obese children the population that is drawing the most attention? First, biologists studying this epidemic have noted that fact that the gene pool in the United States has basically remained the same over the past 15 years. This tends to rule out any possible explanations dealing with actual evolutionary changes or modifications in the human body. As a result, scientists tend to believe that the causes of the increase in children’s weight are a product of environmental effects on metabolism.

At any rate, it is shown that individuals who are obese as children are most likely beginning a lifelong fight (Dietz & Gortmaker, 2001). Present studies have shown that approximately 95% of obese individuals who succeed in loosing weight tend to gain almost all of it back over time (Koplan, Liverman & Kraak, 2005). This statement is supported by our ever-increasing percentage of obese adults. In 2001, statistics show that there were 29 states containing a percentage of obese adults of 20% or greater.

Hence, prevention at the earliest possible age is said to be the only hope for success in stopping this seemingly out of control problem. It is shown that the younger the child is, the less likely he or she will have developed bad eating habits. Also, younger children tend to be much easier to work with as oppose to stubborn teenagers who may not accept parental influence.

All in all, childhood obesity tends to result in numerous mental, physical and social health disorders for the growing individual. Without immediate intervention at a young age, obesity in children may continue to grow (Kimm & Obarzanek, 2002).

The following writing will continue to decipher the issue of adolescent obesity and will expose crucial concepts, theories and assumptions dealing with each discipline involved. Biology will first be discussed with the goal of further defining the physical and biological effects of childhood obesity. One must understand how the child physically becomes obese and what biological factors are involved.

Next, sociology will be addressed with the goal of educating the reader of the impacts that society has on obese children. Are there any direct causes of obesity that society may have initiated? Finally, business will be mined for possible ways that large companies and organizations have affected the issue. Are these interventions effective or are they merely ways to mask the problem?

In conclusion, each discipline involved offers its own understanding of childhood obesity. One must take each possible approach into consideration in hopes of forming a new more comprehensive explanation. An interdisciplinary approach is used in this situation to help organize the inputs of the disciplines and then synthesize them into a new holistic picture. This process helps to avoid a biased opinion, which is likely formed by increasing specialization of the disciplines. Furthermore it attacks the issue from every angle within the reach of the disciplines used (Repko, 2005).

References

Biology

Dietz, W., & Gortmaker, S. (2001). PREVENTING OBESITY IN CHILDREN AND

ADOLESCENTS.

Annual Review of Public Health

,

22

(1), 337. Retrieved

February 29, 2008, from Academic Search Complete database.

Kimm, S., & Obarzanek, E. (2002, November). Childhood Obesity: A New Pandemic of

the New Millennium.

Pediatrics

,

110

(5), 1003. Retrieved February 8, 2008, from

Academic Search Complete database.

Rosenbaum, M., & Leibel, R. (1998, March). The physiology of body weight regulation:

Relevance to the…

Pediatrics

,

101

(3), 525. Retrieved February 29, 2008, from

Academic Search Complete database.

Vessey, J., & MacKenzie, N. (2000, September). Childhood Obesity: Strategies for

Prevention.

Pediatric Nursing

,

26

(5), 527. Retrieved February 8, 2008, from

Academic Search Complete database.

Sociology

Green, G., & Reese, S. (2006, Fall). CHILDHOOD OBESITY: A GROWING

PHENOMENON FOR PHYSICAL EDUCATORS.

Education

,

127

(1), 121-124.

Retrieved February 29, 2008, from Academic Search Complete database.

Koplan, J., Liverman, C., & Kraak, V. (2005, Spring). Preventing Childhood Obesity.


Issues in Science & Technology

,

21

(3), 57-64. Retrieved February 4, 2008, from

Academic Search Complete database.

Schwartz, M., & Puhl, R. (2003, February). Childhood obesity: a societal problem to

solve.

Obesity Reviews

,

4

(1), 57-71. Retrieved February 29, 2008, from

Academic Search Complete database.

Business

Harper, M. (2006, October). Childhood Obesity.

Family & Community Health

,

29

(4),

288-298. Retrieved February 29, 2008, from Academic Search Complete

database.

Other disciplines

Repko, A (2005).

Interdisciplinary practice a student guide to research and writing

.

Boston, MA: Pearson Custom Publishing.

Advantages and disadvantages of qualitative and qualitative methods in nursing

/in /by

Advantages and disadvantages of qualitative and qualitative methods in nursing

The theoretical foundations of qualitative and quantitative methods are very different, but many researchers believe both methods should be used in the research study to increase validity and reliability.

What advantages or disadvantages do you see in using both types of methods in a nursing study? Support your answer with current evidence-based literature.

Analyze the flow of data and information among disparate health information systems to support internal and external business processes

/in /by

Analyze the flow of data and information among disparate health information systems to support internal and external business processes

Case Study, Stage 2: Data Flow Among Health Care Systems

Before you begin this assignment, be sure you have read the “UMUC Family Clinic Case Study”, the course readings assigned to date, and feedback on your graded Stage 1 assignment.

Purpose of this Assignment

This assignment specifically addresses the following course outcomes to enable you to:

Analyze the flow of data and information among disparate health information systems to support internal and external business processes
Examine the implications of ethical, legal, and regulatory policy issues on health care information systems

UMUC Family Clinic Medical Practice

In your Stage 1 assignment, you created process models for the patient visit process in the UMUC Family Clinic. For the Stage 3 assignment, you will identify an Electronic Health Records System that will address the process problems at the Clinic. The EHR system you identify will initially be implemented at the UMUC Family Clinic, but will soon need to be able to connect and communicate with external systems. As part of analyzing the requirements for the new system, one step is to consider how that system will enable the UMUC Family Clinic to exchange electronic data with other health organizations – such as other providers, pharmacies, insurance companies, and even patients themselves. The case study mentions several of these. For this assignment you will select two types of external organizations and describe what kind of data would flow between the UMUC Family Clinic and those organizations and how that can be done effectively.

A GROUP OF MEDICAL RESEARCHERS INVESTIGATED THE EFFECTS OF DRUG X ON LOWERING CHOLESTEROL LEVELS IN A GROUP OF MEN BETWEEN THE AGES OF 50 AND 70 YEARS OLD.

/in /by

A GROUP OF MEDICAL RESEARCHERS INVESTIGATED THE EFFECTS OF DRUG X ON LOWERING CHOLESTEROL LEVELS IN A GROUP OF MEN BETWEEN THE AGES OF 50 AND 70 YEARS OLD.

THE RESEARCHERS DID THE FOLLOWING EXPERIMENT AND OBTAINED THE INDICATED RESULTS: ONE GROUP OF 150 MEN TOOK A TABLET CONTAINING DRUG X FOR 3 WEEKS – 95 OF THESE MEN DECREASED THEIR CHOLESTEROL LEVELS BY AT LEAST 10% (THREE MEN FROM THIS GROUP DROPPED OUT OF THE STUDY).

1. What is the correct sequence of steps in the scientific method?

Make observations and ask a question
Analyze the data
Develop a hypothesis
Share the results with other scientists
Design and perform an experiment to test the hypothesis

a) I>II > III > IV > V

b) III > I > V > II > IV

c) V> IV > III > II > I

d) I> III > V >II > IV

e) V > II > I > III > IV

2. You have formulated a hypothesis: “Apples contain more vitamin C than oranges.”

To test your hypothesis you measure vitamin C levels in 20 oranges and 20 apples from trees that were grown in the same orchard under the same environmental conditions (temperature, rain, sunlight). This experiment was conducted twice. The control in the experiment is__________________________________.

a) type of soil, temperature, amount of rain and sunlight in the orchard

b) vitamin C levels

c) oranges

d) apples

e) a large sample size and repeated experiment

***Use the following information to answer questions 3, 4,5 & 6 below***:

A group of medical researchers investigated the effects of Drug X on lowering cholesterol levels in a group of men between the ages of 50 and 70 years old. The researchers did the following experiment and obtained the indicated results: One group of 150 men took a tablet containing Drug X for 3 weeks – 95 of these men decreased their cholesterol levels by at least 10% (three men from this group dropped out of the study). Another group of 150 men was given a tablet with no added Drug X for 3 weeks – 10 of these men decreased their cholesterol levels by at least 10% (two men from this group dropped out of the study).

3. Which of the following is the best hypothesis for this experiment?

a) Will drug X lower cholesterol levels in men between the age of 50 and 70 years?

b) Drug X will lower cholesterol levels in men.

c) Since high cholesterol levels significantly increases several health risks for men, drug X is most likely beneficial.

d) Men between the age of 50 and 70 years will have reduced cholesterol levels if they take drug X over a 3 week period.

e) There is no significant difference in cholesterol levels between men that take drug X and those that don’t take it.

4. Which of the following was the control group in this experiment?

a) The amount of Drug X contained in the tablet

b) The number of participants in each group at the end of the experiment

c) The group of participants that received tablets containing Drug X

d) The group of participants that received tablets that did not contain Drug X

e) The number of participants in each group at the beginning of the experiment

5. Which of the following is a dependent variable in this experiment?

Prevention interventions to address the opioid crisis | nursing | Chamberlain College of Nursing

/in /by

The alarming opioid crisis, with its staggering death rates, is affecting the life expectancy rates of Americans. Select one of the populations on the map and address the following:

I selected Florida:

Opioid-Related Overdose Death Rates (per 100,000 people) (2016): 14.40

Opioid Pain Reliever Prescriptions (per 100 persons) (2015): 62.80

1-Compare the opioid-related overdose death rates of the selected population to national opioid-related overdose death rates.

2-Identify one primary, one secondary, and one tertiary prevention intervention to reduce the misuse of opioids in the selected population.

3-Describe one evidence-based strategy to address provider opioid prescription rates.

4-Identify the stakeholders charged with addressing the opioid crisis in your community.

5-Share your professional experience related to the topic. (i work in hospice and we use a lot of opiod)

Please answer each question separated and use at least 3 sources no later than 5 years.

Health Promotion Strategies for Smoking Cessation

/in /by


Drawing on appropriate literature, provide a critical analysis of the application of health promotion philosophies, principles and approaches underpinning public health practice in relation to a relevant topic (e.g. any public health policy in the UK)

The chosen public health topic is smoking. The student has selected this subject because it is a current issue of particular relevance because of the prohibition to premises becoming smoke- free if they are open to the public, due to be enforced in England in July 2007 (Health Act 2006). Smoking is also an important topic because it has been identified as the single most significant public health problem in the UK (Royal College of Physicians 2000); approximately 114,000 smokers in the UK die as a result of smoking (Action on Smoking and Health 2005). The treatment of smoking- related conditions costs the National Health Service (NHS) up to £1.7 billion per year with an estimated cost of £1.7 million to British industry every year as the result of lost working hours caused by smoking- related illness (Gommans 2005).

According to Tannahill (1985) health promotion is a broad concept which encompasses health education and health prevention. Health education refers to working with groups and individuals to promote healthy behaviours, whereas health prevention refers to strategies which prevent ill- health such as immunisation.

Public health is defined as:

‘The science and art of preventing disease, prolonging life and promoting health through organised efforts of society’ (Acheson 1988)

This definition implies a collective approach; however public health has been criticised as being medically dominated (McPherson 2001).

Philosophies of health promotion provide a framework for exploring our rationale and justification for wanting to change health- related behaviour. Seedhouse (2002) refers to health promotion as a ‘moral endeavour’; in other words health professionals are required to make judgments about if, how and when to intervene in relation to the health behaviours of patients, clients and service users, taking into account individual needs and priorities. In some cases health behaviours affect not only the individual but others, also; this applies to the effects of secondary smoking, for example. Taking into account the secondary effects of health behaviours may impact upon the ‘moral endeavour’ of health professionals and health policy makers. Moral judgements underpin the work of health professionals; the student recalls an incident when a lady aged 100 who had smoked all of her adult life and who clearly did not have long to live, asked to be helped to smoke a cigarette. This simple act gave her pleasure and it seemed irrational and unkind not to respond to her request. Moral judgements are not always straightforward.

Philosophical principles applicable to health promotion include logic; the development of reasoned argument (Naidoo and Wills 2000a). Our arguments for changing health-related behaviour are evidence- based involving for example, the type of statistics about smoking highlighted in para 1 of this page. There is a large body of evidence which supports the argument that smoking is damaging to health and yet, as discussed further on (para.2, p.4), it can be seen that individuals do not always respond to logical reasoned argument in relation to modifying health- behaviours.

Epistemology, another philosophical principle, is concerned with the debate about truth, in this case exploring what health really means. There are different models of health including the medical and social models. The medical model is concerned with the categorisation of illness and disease and with specific medical interventions given by the ‘expert’ (the health professional) to the patient, who has traditionally been a passive recipient of this expert advice and intervention. A social model of health involves a broader interpretation of health which is influenced by a range of determinants, such as age, gender, socioeconomic factors, education and environment. Within this model, strategies to improve health status adopt a wider perspective than the medical model, seeking to address the aforementioned determinants. In relation to health promotion, the medical model might not take into consideration, factors which affect the individual’s behaviour such as their socioeconomic status. There is evidence that smoking behaviour is more prevalent among more disadvantaged socioeconomic groups (Gulliford et al 2003). It is important therefore to take into consideration this and other, factors when developing health promotion strategies and not to reduce the issue to one of the giving and receiving of information with an assumption that behaviour will be modified as a result.

Health promotion philosophies are also concerned with ethics. The theory of ethics is divided into two main categories: deontological and consequential. Deontology is concerned with our duty to behave according to a set of moral principles. On page 1, paragraph 5, the issues/ dilemmas involved for health professionals in making moral judgements, were referred to. Consequential ethics are based on the premise that a judgment about whether an action is right or wrong is dependent on its end result, in other words whether the ends justify the means. This has some interesting implications for health promotion. Further on (p.4) some health promotion strategies are discussed including a debate about the use of legislation, i.e. enforcement, to bring about health- related behavioural change. As stated earlier (para.1, p.1) this issue is of particular relevance to smoking. The argument for enforcement is that the end result of reducing smoking behaviours and resultant improvement in health status as well as savings made to the cost of healthcare, justifies the prohibition legislation.

Broad approaches to health promotion reflect the models of health referred to (para. 2 on this page) and are categorised by Naidoo and Wills (2000b) as medical/ preventative; behavioural change; educational; empowerment and social change. Within the medical approach there are three levels of prevention: primary, secondary and tertiary. To apply these specifically to smoking; the primary level aims to prevent smoking behaviour before it begins, the secondary level is concerned with preventing the recurrence of a smoking- related illness or disease by encouraging the patient to give up smoking and the tertiary level is about promoting quality of life within a chronic condition such as diabetes, in which case the message would be that the individual’s quality of life would be optimised if they do not smoke.

The behavioural approach focuses on lifestyle issues (Laverack 2004) Emphasis is placed upon the individual’s responsibility for health which does not take into account factors outwith the individual’s control and as such, this approach has been criticised for being ‘victim- blaming’ (Tones and Tilford 2001), shifting responsibility away from the government for example, in relation to individual health status.

The educational approach is less about placing responsibility on individuals in relation to their health- related behaviours and more about giving information and facilitating people to make informed choices about their lifestyle choices. This approach relates to the rational- empirical strategy described further on (para. 2, p.4) as it is based on the assumption that giving people information will lead to attitudinal and behavioural change. As will be seen, this does not always happen. This approach is also dependent on a level of concordance from the individual, for example a commitment to attend regular sessions as part of an educational programme.

The empowerment approach reflects the normative- re-educative strategy described further on (para. 4, p. 4) and entails giving people the means to have increased control over the determinants that affect their health status. This involves community participation, a collective approach which is embedded within the philosophy of public health. According to Laverack (2004) there can be different interpretations of what constitutes a ‘community’. We tend to think in terms of a geographical community; a locality. It might be more effective in health promotion terms to think of a community as a group with shared characteristics, such as young people. The reality of community participation is that it tends to be more evident among communities who are educated and higher up the socioeconomic scale. People who are disadvantaged are less lilkely to be motivated to participate in health- related programmes- they may feel marginalised and are preoccupied with the issues that their situation presents, such as concerns about housing and income; health promotion is not viewed as a priority, and smoking might be used as a means of helping them to cope with adversity (Hanson Hoffman 1998).

This leads onto the notion of the social change approach. This is quite a complex concept that involves health promotion initiating and driving social change in order to improve conditions that are conducive to health (Erben et al 2000). Social change would involve making the sorts of improvements that would place health issues more firmly on everybody’s agenda. There are many factors that contribute to social change such as legislation and shifts in ideas about codes of behaviour. For example, attitudes about sexual behaviour have changed over the years, contributing to health issues such as increased incidence of sexually transmitted disease and a rise in teenage pregnancies (Measor et al 2000). There is some indication that social attitudes to smoking have changed (Moonie 2005) which is arguably, a positive development; some smokers report that they feel like social pariahs! The social change approach is underpinned by an acknowledgement of the complexity of what influences health- related behaviours and can be linked to the social model of health, discussed in para. 2, p.2.

Specific health promotion methods are quite diverse including: giving information in a didactic manner, for example via talks to large groups; lobbying local health and Government authorities; making use of the mass media (for example there is currently a television information advertisement about the early signs of myocardial infarction); working with groups; teaching social or life skills that are related to health status; publicity events, e.g. health fairs; facilitating community groups; enforcing health regulation; one to one advice and education; networking and liaising with other workers; instructing on specific techniques, such as self-administration of insulin; facilitating self help groups and enabling health promotion by the provision of support services such as childcare and interpreting facilities (Naidoo and Wills 2000c). Most of these methods can be adapted for use with smoking cessation.

The change strategies framework by Bennis (1976) can be applied to health behavioural change and is of particular relevance to anti- smoking legislation. It includes three strategies for bringing about change which are based on different assumptions about human behaviour, and which, when applied to health promotion, involve three distinctly different approaches. The first strategy (rational- empirical), is based on the supposition that ‘knowledge is power’. Within this strategy it is assumed that an individual will modify their health- related behaviour in response to receiving reliable and valid information. For example, if the government or a health professional issues advice about the dangers of smoking, the individual should reduce or cease their smoking habit. It is well- known that this often does not happen; even some health professionals smoke, despite their level of knowledge about the dangers (McKenna 2001). The reasons for this are usually related to dependence. It is also possible that human beings adopt Freudian mental defence mechanisms, which are maladaptive coping strategies used (in this instance) to circumvent evidence of the negative consequences of a health- related behaviour, such as smoking. These include denial, intellectualisation (which involves citing contradictory evidence), or rationalisation, among others (Lupton 1995). Resorting to these defences can undermine the power of knowledge and evidence, however valid and reliable it is.

The second strategy (power- coercive) involves the use of legislation and policy change in order to enforce health- related change. A good example of this is the anti- smoking legislation referred to in paragraph 1, page 1. There is some evidence to demonstrate that no- smoking policies do have the effect of reducing smoking behaviour (Brigham et al 1994). There has been criticism of the legislation as it is seen by some as an infringement of the individual’s right to choose. However this view is countered by the argument that the health of non- smokers can be adversely affected by cigarette smoke, and these people have the right to be protected (HM Treasury 2004). It appears that many non- smokers feel that they should be safeguarded from the effects of passive smoking (Pilkington et al 2006).

The first two strategies adopt a ‘top- down’ approach whereas the third strategy (normative- re-educative) is based on the assumption that an individual is more likely to change their health- related behaviour if they have had involvement in bringing about the change; if they feel empowered. This approach underpins some of the health promotion strategies referred to in para. 1 of this page; for example facilitating community groups. However as discussed earlier (para. 2, p.3), it seems likely that community participation and empowerment might be of limited value within certain groups, such as people who are disadvantaged or marginalised.

In conclusion, it appears that a multi- faceted approach needs to be adopted in order to address health- behaviours which are harmful to health, in this instance smoking. The starting point is that there is incontrovertible evidence that smoking is harmful to health, and can lead to premature death, as cited in para.1, p.1. The question of whether we have the right to choose to smoke can be challenged because of the evidence- base that demonstrates that smoking can affect the health of others (para. 3, p. 4). However it is important to recognise that people who smoke need adequate support and resources in order to be able to stop. There is existing evidence that legislative and policy change can reduce smoking behaviours (para. 3, p.4) and it will be interesting to see the outcomes of the current legislation (para. 1, p. 1). However, smokers also need clear, unambiguous messages about the effects of smoking, consistent support from health professionals and accessible information about smoking cessation services (Kerr et al 2006).


References

Acheson D. Independent Inquiry into Inequalities in Health: Report. London Stationery Office 1988.

Action on Smoking and Health Factsheet No. 2. Smoking Statistics: Illness and Death. ASH 2005.

Bennis et al The Planning of Change Holt Rinehart and Winston 1976

Brigham J, Gross J, Stitzer M and Felch L Effects of a restricted work-site smoking policy on employees who smoke.

Am J Public Health

. 84(5): 1994 pp. 773–778.

Department of Health. Health Act 2006. Part 1 Chapter 1. 2006.



Erben R, Franzkowiak


P and Wenzel E. People empowerment vs. social capital: from health promotion to social marketing.



Health Promotion Journal of


Australia

. 9(3) 2000 pp. 179-182

Gommans J, Bunton J and MacDonald G. Health Promotion: 2nd Edition. Routledge. 2005. p.189.

Gulliford M, Sedgwick J and Pearce A. Cigarette smoking, health status, socio-economic status and access to health care in diabetes mellitus: a cross-sectional survey.

BMC Health Service Research

2003 pp. 3: 4.

Hanson Hoffman. Recovery from Smoking – Second Edition: Quitting with the 12 Step Process – Revised Second Edition. Hazelden. P.1

Kerr S, Watson H, Tolson D, Lough M and Brown M. Smoking after the age of 65 years: a qualitative exploration of older current and former smokers’ views on smoking, stopping smoking, and smoking cessation resources and services.

Health


and Social Care in the Community

. 14(6) 2006 pp. 572-582,

Laverack G. Health Promotion Practice: Building Empowered Communities. Sage publications. 2004. pp. 21, 22, 44.

Lupton D. The Imperative of Health: public health and the regulated body. Sage Publications. 1995. p. 111.

Mckenna H, Slater P, McCance T, Bunting B, Spiers A and McElwee G. Qualified nurses’ smoking prevalence: their reasons for smoking and desire to quit.

Journal of Advanced Nursing.

35(5). 2001. pp.769-75

McPherson K. Public health does not need to be led by doctors: for.

BMJ

. 30; 322(7302) 2001 p.3–1596.

Measor L, Tiffin C and Miller K. Young People’s Views on Sex Education: Education, Attitudes and Behaviour. Routledge 2000. p.4.

Moonie N (Ed.) GCE AS Level Health and Social Care Double Award Book. Harcourt Heinemann. 2005. p.29

Naidoo J. & Wills J. Health Promotion: foundations for practice (2nd edition). London, Baillière Tindall 2000. pp. 113

Pilkington P, Gray S. Gilmore and A. Daykin N. Attitudes towards second hand smoke amongst a highly exposed workforce: survey of London casino workers.

Journal of Public Health.

28(2) 2006 pp.104-110

Royal College of Physicians. Nicotine addiction in Britain: A report of the Tobacco Advisory Group of the Royal College of Physicians. RCP 2000.

Seedhouse D. Ethics: the heart of healthcare. Second Edition. John Wiley and Sons.. 2002. Chapter 2

Tannahill A What is Health Promotion?

Health Education Journal

44(4) 1985 pp. 167-8

Tones K and Green J Health Promotion: Planning and Strategies. Sage Publications. 2004. p. 16.

Tones K and Tilford S. Health Promotion: effectiveness, efficiency and equity. Nelson Thornes. 2001. p. 28.


Total word count 2752

Adherence to professional standards is not always enforceable. Provide an example that demonstrates this concept. What do think should be done to make the standard enforceable?250 words or more

/in /by

Adherence to professional standards is not always enforceable. Provide an example that demonstrates this concept. What do think should be done to make the standard enforceable?250 words or more

1. It is important for professionals to conduct themselves according to their discipline’s standards to promote the general good of the discipline. However, adherence to professional standards is not always enforceable. Provide an example that demonstrates this concept. What do think should be done to make the standard enforceable?250 words or more

2. Health Care Administrators: http://www.hcaa.org/ Please review the website and discuss the primary function of the organization and identify professional standards of practice discussed on the website. How do these standards of practice relate to your professional development plan?250 words or more

3. Describe an interview, or interview question, that you found to be difficult. How did you handle it at the time and, in retrospect, what might you have done differently?250 words or more

4. Your résumé/CV is an essential component of your professional portfolio. How is it used to convey your professional identity prior to the job interview?250 words or more