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HPV Vaccine: Barriers and Mitigation
According to the Center for Disease Control (2012), the HPV vaccine has over 97% effectives in preventing cervical cancer cases in the globe. There is need for using the vaccine and convincing stakeholders to fully integrate its use in the community because of high levels of sexual activity among preteens and adults.
The stakeholders for the project are Hispanic pediatrics aged 10 to 13 years and their parents who would serve as advocates and champions of the vaccine. This section of the HPV vaccine based project will discuss the potential barriers to the implementation of the project. The stakeholders are likely to pose a challenge in the intended wide vaccination of preteens, thereby posing a need to addressing and preventing those barriers.
The stakeholders might hold insufficient information about HPV and therefore not know about the existing risks that are already posed by the pathogen. Such parents or guardians are also likely to be unaware of the wide prevalence of the disease, and therefore, the risks that it poses to their children’s health (Caitlin, Escoffery, Satsangi & Brownstein, 2015).
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The project will consider an education program that gives talks about the causes, transmission and prevention methods that can be used in fighting the Human Papilloma Virus. The project will involve Spanish speaking volunteers that can integrate Hispanic values into the dispensation of information about the condition (Butts, Janie, and Rich, 2010). The project will also enlist the assistance of religious organizations, politicians, local celebrities, and community centers. One of the reasons why HPV is highly prevalent is the low manifestation of symptoms among those that are infected.
Therefore, those that are infected are likely to infect a high number of partners especially if they do not practice safe sex. HPV poses the threat of causing cervical cancer which might be difficult to treat if it is detected late. If this information is dispensed through the correct avenues, it might contribute to the mobilization of the Hispanic parents (stakeholders) to allow their children to be vaccinated with the HPV vaccine.
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The Crips and The Bloods: Made in America
The documentary, “Crips and bloods: Made in America”, portrays the rise of gang life in Los Angeles and throughout the United States. Stacy Paralta presents the inherent growth of gang and crime life in the post-World War Two American Society. With the onset of the economic recession, the living standards of many Americans greatly deteriorated. Many young men found solace in deviant activities to manage the tough economic conditions.
Many youths in the United States Predominantly African-Americans, Hispanic and Latino’s were facing segregation in the access of services and opportunities. The current paper seeks to analyze the historical timeline of gangs and gang activities in south central Los Angeles as presented in the documentary, “Crips and bloods: Made in America”.
Racism during the economic recession led many marginalized American citizens to live in deplorable conditions. Greater resentment and mistrust of others among African-American communities emerged due to the inequality and injustice imposed against them.Brutality and victimization was at an all-time high, with injustices against African Americans in police arrests. In addition, there was open intimidation, with random police checks and a continued scrutiny of African-Americans. In August 1965, the Watts riots in Los Angeles were fueled by the arrest of African Americans for driving while drunk. This form of inequality stimulated deviance and development of gang life in American society.
Economic slowdown drastically reduced employment opportunities for marginalized groups and directed increased advocacy for equality. As a result,there was emergence of more civil disobedience and escalating violent demonstration to articulate the inequalities.The challenges had a significant impact on family structures where most children ended up as orphans due to crime. Further, owing to the tough economic situations, family members resorted to join gang life because of the economically lucrative and simple life. In addition, others saw these as a viable avenue of deviance to fight the banal inequality in the American society.
As presented by Stacy Paralta in the film, the Crips and the bloods gang were formed over 30 years ago in Los Angeles and have now spread to over 123 cities and 33 states in the United States. The Crips was established by two African-American students Raymond Washington and Tookie from South Central Los Angeles High School. It emanated from gang which was named “Baby Avenues” during the time in 1960’s. The motive of establishing the gang according to Raymond was for protection against other violent gangs committingcrimes.
The Crips expanded to the most parts of the Los Angeles city with most of its activities based on the high school campuses. Initially, the Crips entailed three factions; the Eastside Crips, Westside Crips and the Compton Crips. According to the documentary, most of the other gangs within the area of Los Angeles affiliated, labelling of their gangs to the Crips. The criminal activities of the Crips revolved around extortion of other gangs, assault and robbery.The pioneer founders of the gang dissociated themselves from the gang. Raymond Washington was killed in 1979 and Tookie imprisoned for murder.
With the spiraling of the Crips dominance throughout Los Angeles, the Piru street boys, a gang composed of the mostly African-Americans emerged in the 1970’s. Both the Crips and Bloods had rituals for all the members before they join and also a symbol of loyalty. They had a membership of youths aged between fourteen to twenty-four. Further, the gangs were territorial exhibited brutal violence in their expansion. Initially, the gang was a set of the Crips until the confrontation of Sylvester Scott and Benson Owen by the Crips. They later broke off its membership after calling on other gangs victimized by the Crips which led to a serious conflict.
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The gang was formed to fight against the increasing dominance of the various Crip gangs in the city. Sylvester Scott and Vincent Owens created the gang based in West Piru Street in Compton Los Angeles. Piru street boys enjoyed new membership from members who exited the Crips. As a result, they formed an affiliation and was named the “bloods”gang. A serious feud between the Crips and the Bloods ensued which saw one of the most violent and bloody gang related killings in South Los Angeles.
The continued violence between the Crips and the Bloods was greatly fueled by the Narcotics trafficking business. In the 1980’s, inception of crack cocaine into the American market led to the increased gang based violence. The Crips and the Bloods are credited with most distributions and drug dealing activities throughout the United States. The fight for new territories among the two gangs has continuously sustained the highly violent feud. The high stakes in the drug business augmented the new heights in the crime the gangs are willing to engage in.
The gang life has gradually been entrenched into the popular American culture.Social organization of the youth have fostered the integration of practices such as graffiti and tattooing. These are very important symbols in the communicating among the gang members. In the education system, schools have become crucial socializing agents for induction of most teenagers into crime life. Crime norms and ideals are learnt through socializing with other students in addition to provision of incentives to joining crime life.
The high level of bullying evident in most high schools in America can be attributed to the gang socialization in community. In the business sector, gang life has permeated into the daily operation of legal businesses. Entrepreneurs engage in extortionists activities to solicit money and business deals. In addition, bribery and protection fees for businesses have become part of everyday business transactions.
In conclusion, the advent of gang life in the United States as depicted by the documentary is largely ascribed to economic challenges and social injustices. Most of gangs were formed to contest against the blatant segregation of African-Americans, Hispanics and Latino communities. Formation of these gangs disintegrated the conventional way of businesses and family operations. Bloody violence increased number of violent murders leaving many orphaned. Furthermore, intimidation was entrenched as the new way of conducting business.
References
Stacy Peralta, S. G. (Writer), & Paralta, S. (Director). (2008). Bloodz &Crips – Made in America [Motion Picture]. Retrieved from https://www.youtube.com/watch?v=vdv08c0aiTE
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Teenage Violence
Forster, M., Grigsby, T. J., Unger, J. B., &Sussman, S. (2015). Associations between gun violence exposure, gang associations, and youth aggression: Implications for prevention and intervention programs. Journal of criminology, 2015.
Summary
Forster, Grigsby, Unger and Sussman (2015) conducted a study that investigated the link between gang association, exposure to neighborhood violence and social self control to incidences of aggression at school. The study collected data from minority youths from three Southeast Los Angeles schools. In the literature review, the authors show that aggression is a serious problem in schools. According to Forster et al (2015), over 600,000 teenagers reported assault related injuries annually, in addition, between 20 and 40 percent of school going students had experienced a bullying incident at school. The literature review also revealed that between 700,000 and 1,000,000 teenagers were members of gangs.
Past studies have shown that exposure and association to gangs, affiliation with delinquent peers, and family processes are indicators of violence perpetration and victimization. To investigate the link between the variables, the study sampled 77 female and 87 male 7th and 8th graders in three South Los Angeles middle schools. Questionnaires were used to collect data on substance abuse, demographics, social self-control, and family and peer gang association, neighborhood violence and self-reported aggression.
The study reported that teenagers with high levels of social self-control were less likely to be involved in past week aggressive episodes. Students with friends who were members of gangs reported 91 per cent higher incidents of aggressive episodes. For girls, aggression was 46 per cent higher if the family was affiliated to gangs. Exposure and fear of gun violence also increased the incidence of aggressive episodes by 26 per cent. According to the study, students were most likely to be involved in aggressive incidents if they were male, had friends associated with gangs, and had low levels of social self-control.
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Critique
Forster, Grigsby, Unger and Sussman (2015) is useful study as it explores an area of research where there exist little empirical evidence to link the variables. It is worthwhile to note that the research provides an insightful background on the teenage and school violence. The author then seeks to investigate the factors that lead to high rates of aggression among teenagers and school going students. Unfortunately, the research only sampled 164 students which is a small sample to facilitate the generalization of the results of the study to the general population.
In addition, the study was conducted in only three schools in the South Los Angeles area where gang violence and gun crime is common (Forster et al, 2015). It is obvious that teenage aggression in other areas may be driven by other factors apart from association with gangs and exposure to gun violence. However, the results than link social self-control to lower levels of self-reported aggression can be generalizable to other student populations.
Using self-reported measures is also a major weakness of the study as the students may fail to report honestly on most of the data collected. Observation would have been a better option for collecting the data on past week aggression as opposed to self-reported measures of aggression. Using observation, the researcher would have been able to see and record incidents of aggression rather than hear about them from the participants.
The study rightly concludes that school based interventions can be used to disrupt the development of aggressive behavior. School based programs can help indeed help in the development of social self-control which has an inverse relationship with the development of aggressive behavior.
Application
Forster et al (2015) is a very useful study in research on teenage violence, and associated the associated study areas. The study provides valuable statistics on the state of teenage violence indicating that more than 600,000 school age children report aggression related injuries every year. The study helps to illustrate that teenage violence is a serious problem affecting many school going children and it is an area that warrants further research.
Most importantly, the research identifies some of the factors that are predictors of teenage violence perpetration or victimization. The study reveals that association with gangs and gang members is a contributing factor to aggressiveness among teenagers. Other impacts of gang association such as the tendency to use substances and other truant behaviors can also be investigated in future studies in the area.
The study also reports an inverse relationship between social self-control and incidents of teenage aggression. Further studies also need to be conducted to establish whether self-control can decrease aggression among teenagers who associate with gangs, and have been exposed to gun violence. The study also indicates that self-reported measures of aggression were limitations of the study, and thus another method of data collection like observation can be used for future studies. The study design also provides a research model that can be expanded for future research in the area of teenage truancy and violence.
The research sample for future research on the topic can be expanded to more schools from more heterogeneous school districts to ensure the results can be generalized. Therefore, Forster (2015) is an important research article that provides preliminary evidence linking association with gangs, social self control, and family association with gangs with teenage violence perpetuation. Most importantly, the study establishes several directions for future research in the area.
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The Four Business Elements: A Consultancy Report
Instruction
Elbanna (2009) asserts that the use of the four elements concerning the business management to different corporate is considered one of the most important aspect. Nonetheless, proper and successful implementation of a business financial program requires the full application of the four famous four functions concerning the management of the business (Elbanna, 2009).
The major purpose of creating incorporate the best business ideas is to ensure that the best business ideas have been applied in parliamentary procedure to create a solid institution and production background, which is likewise run by a highly productive team (Ajmal et al., 2009). Therefore, this paper will delve on determining how the appropriate implementation of the four business elements can be employed to manage the Outdoor Adventure called Outdoor Paintball Park.
How the Four Business Elements can be used to improve the outdoor venture
First, it is worth noting that the Outdoor Adventure Paintball Park is one of the most contemporary businesses that offer Outdoor Adventure. The appropriate adoption and the application of the business management tool is considered important, especially considering that the out adventure has continued experiencing some of the most important management inefficiencies (Rind Christensen & Klyver, 2006).
Therefore, the use of the P-L-O-C platform will help pinpoint some of the issues that have ended up affecting the company’s effective performance and how the move can improve the rate of the goal attainment (Elbanna, 2009). As a result, several issues will be covered during the recommendation stage, which includes important facts such as the;
The need for devising a proper and mind blowing business statement concerning the business
Creating a better way that will improve the management of scarce organizational resources such as the enactment of a proper and a functional personnel
Laying more emphasis on the need for recruiting employees through training in order to make them fit and ready to work within the new company
Creation of a proper mechanism that can be used to conduct tom improve the standard, as well as other forms of the measurable outcomes
Devising a good mechanism that can pave way for the effective achievement of the organizational achievements where the members should be encouraged to use the P-L-O-C principles and practices
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The Incorporation of the Proper Planning Procedure
First, it is imperative noting the use of a proper planning procedure is considered one of the most important aspects when it comes to devising the proper ways that can improve the business performance (Rind Christensen & Klyver, 2006). As the financial business consultant, one should understand that he/she is supposed to make sure the businesses can only be implemented through the appropriate setting of the business objectives (Elbanna, 2009).
Moreover, the consultant should also demonstrate, clearly, how the business owner(s) should come up with a proper management the set goals in a more clear and effective manner (Ajmal et al., 2009). Some of the business activities and aspects that can be improved through the appropriate use of planning procedure include;
The setting up of a good mission and vision statement- here, it will be appropriate devising an appropriate mission and vision statement for the new company since it is clear it lacks one. Thus, some of the recommended mission and vision statement are listed below;
“The achievement of happiness among the teenagers, working teams, and the young adults, through offering the best outdoor experience, is our ultimate and final goal as the Outdoor Paintball Park Community.”
“Strive to become the leading and number one company in providing ‘refreshing’ experience of the teenagers and the young adults while becoming a leading source of livelihood to the young adults”
The use of a clear and concise mission and vision statement can help to realign the general process of achieving the overall goals of the Outdoor Adventure. As such, it should be carried out in a more comprehensive and careful manner. In fact, this is the only way the organization will be able to meet its long-run objectives (Cobbold et al., 2004).
The Implementation of the Organizing Procedure
The organization should go ahead with the definition of the culture. It is worth remembering that the birth of the business came as a coincidence when the three family members joined hands (Ajmal et al., 2009). Therefore, in order to achieve a good way of improving the cultures, the organization should integrate it with the themes of the mission and vision statements (Parks, 2000).
The organizational structure should also be created where there should be a clear distinction of each and everyone’s role. The proper implementation of such procedures will help eliminate issues such as the development of conflict during the business development stage (Parks, 2000). Each member should be given the overall authority of achieving certain strategic objectives in order to avoid a collision.
The Incorporation of the Leadership Skills
It is an imperative noting Outdoor Adventure lacks a proper mechanism of defining its leadership hierarchy. Thus, the move has the potential of affecting not only the lowly ranked employees but also the target and potential customers (Cobbold et al., 2004). Therefore, in order to improve the leadership skills, the company should emphasize on the need to providing constant training and undertaking of seminars for the employees who are in the leadership positions.
The move will help expand their mind on how they can handle a diverse workplace and customers (Parks, 2000). As a result, the move will help meet their satisfaction. The other employees should also be empowered, through training them regularly, in order to promote their independent thinking to promote the organization (Cobbold et al., 2004).
The use Control Procedure
The Outdoor Adventure will need to devise a proper way that will be used to define standards, as well as measure the achievement of the target results. The move will make the achievement of the appropriate objectives are highly achievable. For instance, it can make of instruments such as the balanced scorecard (Chavan, 2009). According to Chavan (2009), the use of the use an instrument will help to translate the laid strategies, mission, and vision into a reality.
References
Ajmal, M. M., Nordström, F., & Helo, P. (2009). Assessing the effectiveness of business consulting in operations development projects. Int J Productivity & Perf Mgmt, 58(6), 523-541. Retrieved from http://www.emeraldinsight.com/doi/abs/10.1108/17410400910977073
Cobbold, I., Lawrie, G., & Issa, K. (2004). Designing a strategic management system using the third‐generation balanced scorecard. Int J Productivity & Perf Mgmt, 53(7), 624-633. Retrieved from http://www.emeraldinsight.com/doi/abs/10.1108/175542509109653459
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Organizational Communication System
Introduction
It is important to note that the organizational change is one of the most crucial aspects of an organization that should be taken seriously. This is due to the fact that many different issues, which may hinder the development of an organization, may appear or continue being manifested in a different department within an organization (Hunter, & Perkins, 2012). As a result, it has become extremely important coming up with significant strategies that can try to improve the overall process of service delivery within the organizational setup.
One of the sectors that have continued being marred by different levels of organizational challenges is the health sector. As a result, it has to keep on devising important strategies that can help to improve not only the general image but also the level of service delivery. Therefore, this paper is set to determine some of the important strategies that can be applied in order to improve the level of organizational communication within any heath sector’s settings.
The Communication System and its Challenges within the Health Care Sector
The health care sector is one of the most important areas as when it comes to the process of defining the process of communication. This is due to the fact that communication process is considered done of the most important factor when it comes to enhancing the level of service delivery within the3 sector. The nurses are supposed to have powerful interpersonal communication skills within themselves in order to strengthen their level of taking care of their patients. This is considered highly important, especially when it comes to the process of defining the safety of the patients.
In short, the nurses are supposed to keep a proper communication system not only between themselves but also with their patients (Hunter, & Perkins, 2012). The move will help to ensure they are able to take care of the needs of their patents. They should be in constant improvement of the knowledge they can use to handle the challenges their patients experience throughout the whole health care process.
At this juncture, they should make sure they have established a solid system that can enhance the process of service delivery (Press et al., 2015). In short, the communication process within the health care system has provided the appropriate guidelines for the health care practitioners, as well as the rest of the nurses to devise the appropriate ways that can improve the planning, as well as the implementation of the appropriate changes while at the same time improving the coordination process. In the long run, the implementation of the appropriate changes, in the nursing and the health care facilities’ communication system, will help to bring out the positive changes that are required to improve the level of service delivery.
How the appropriate implementation of the communication system can help to improve the level of service delivery within the nursing system
First, it is imperative understanding that the implementation of the effective communication system within the health care set up can help to improve it in multifaceted ways. For instance, it can help to improve the achievement of the health care’s organizational goals such as having the appropriate way that can be used to improve the process of achieving the mission, vision, and the overall objectives set by the health care. In short, the interpersonal nursing communication can be deemed one of the most effective methods that can help the team of nurses to devise some of the most appropriate strategies that can help to improve their coordination process.
Briefly, it makes them feel not only energized, but also organizes the process of communication by making sure that they have come up with a proper of effective paper work system that can be followed to the latter. Having a proper communication system not only makes the nurses to be responsible professions, but also more cautious when they are dealing with their patients and also with other relevant parties they might interact with when they are delivering their mandated health care roles.
However, one of the important things worth noting is that the nursing system has lacked a proper system that defines the overall process that can be used to improve the communication system (Lyngstad, & HellesØ, 2014). It is beyond reasonable doubt that the nursing system is one of the most important sectors that requires the adequate application of the appropriate approaches that can help to improve the level of the communication system among the parties involved (Press et al., 2015). The appropriate steps that can be used to improve the overall communication in any health care facility is discussed in the section below.
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The appropriate mechanisms that can be used to improve the health care communication system
The communication system within the healthcare set up can be improved using multifaceted ways. First, the professional body should come up with appropriate plans that can bring positive organizational changes within the health care set up (Lukasiewicz, 2015). For instance, they should make sure the complex system that patients are supposed to follow is properly explained or expounded in order to reduce the level of ambiguity that might be involved (Weigand, 2012).
This is due to the fact that the nurses and other health care practitioners might be compelled to make regular changes in the manner they deliver their services to the patients. For examples, the school nurses will need to evaluate the manner in which they communicate with the students in order to avoid or minimize any information delivery mismatch.
The nurses are also supposed to create an effective rapport of communication with the professions with the public health sector (Lyngstad, & HellesØ, 2014). In fact, the proper implementation of such important changes will not only improve the level of their awareness of the sources of deadly illnesses, but also helps them improve the way they can handle different health cases (Hunter, & Perkins, 2012).
The nurses are also supposed to create a good communication system with the physicians. This is due to the fact that the move can help to improve the overall process of delivering quality health care services to the target patients’ ones they are discharged from the hospital (Lukasiewicz, 2015). Furthermore, they can be able to carry out proper monitoring and measurement of the long run outcomes of such patients.
The nurses are also supposed to have a proper interpersonal communication within their working environment (Rowe, & Hogarth, 2005). As a result, they are able to detect most of the changes as they occur, thus, enabling them to devices some of the most appropriate and suitable changes they should apply in order to keep on improving the level of health care service delivery.
References
Hunter, D., & Perkins, N. (2012). Partnership working in public health: the implications for governance of a systems approach. Journal Of Health Services Research & Policy, 17(s2), 45-52 8p. doi:10.1258/jhsrp.2012.011127
Lyngstad, M., & HellesØ, R. (2014). Electronic Communication Experiences of Home Health Care Nurses and General Practitioners: a Cross-sectional Study. Studies In Health Technology & Informatics, 201388-394 7p. doi:10.3233/978-1-61499-415-2-388
Press, M. J., Gerber, L. M., Peng, T. R., Pesko, M. F., Feldman, P. H., Ouchida, K., & … Casalino, L. P. (2015). Postdischarge Communication Between Home Health Nurses and Physicians: Measurement, Quality, and Outcomes. Journal Of The American Geriatrics Society, 63(7), 1299-1305 7p. doi:10.1111/jgs.13491
Rowe, A., & Hogarth, A. (2005). Use of complex adaptive systems metaphor to achieve professional and organizational change. Journal Of Advanced Nursing, 51(4), 396-405 10p. doi:10.1111/j.1365-2648.2005.03510.x
Weigand, M. L. (2012). Nurse-to-Nurse Communication in Home Health. Pennsylvania Nurse, 67(3), 19-22 4p.
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Gastrointestinal disorders
Various gastrointestinal disorders may present with similar symptoms which may make the diagnosis difficult especially when the information provided in the patient history is not sufficient. In the case study presented, the patient presents with the symptoms of weight loss, anorexia, epigastric tenderness, and chronic heartburn. From the information garnered from the patient history, the risk factors included the use of NSAIDS and smoking.
Apart from peptic ulcer disease, gastroesophageal reflux disease, and gastric cancer, the differential diagnosis would include other conditions such as abdominal pain syndrome as well as dyspepsia (Agarwal & Mayer, 2013). The definite diagnosis is difficult to make since the patient did not provide sufficient information regarding the disorder.
For instance, the health care professional ought to ask the patient of the history of the occurrence of such a condition in members of the immediate family so as to rule out any genetic predisposition to the disorder (Agarwal & Mayer, 2013). Also, it would have been important if the patient was asked about having taken opioids or any other related drugs (Talley & Ford, 2015).
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Again it is important that various tests such as imaging tests be taken on the patients to assist in making the definitive diagnosis (Talley & Ford, 2015). Some further tests that should have been done include virtual colonoscopy and computed tomography to examine the patient intensively for any conditions that could have been causing the disorder. Also, magnetic resonance imaging could also have been used to rule out the possibility of the patient having any malignancies within the gastrointestinal system (Agarwal & Mayer, 2013).
More so it is recommended that endoscopy is conducted on the patient to determine or rule out the occurrence of peptic ulcer disease (Talley & Ford, 2015). Additionally, blood tests should be carried out on the patients to determine if they are suffering from the narcotic bowel syndrome.
References
Agarwal, S., & Mayer, L. (2013). Diagnosis and treatment of gastrointestinal disorders in patients with primary immunodeficiency. Clinical Gastroenterology and Hepatology, 11(9), 1050-1063.
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Child Development Theory and Practices
Introduction
Childhood development is the theory and practice of procedures to ensure that the child is given the proper resources, guidance and nutrition to see them through their infancy up to middle school. Child development can also be the biological, social and psychological change in a child as they grow. However, it is supported by the various efforts and developmental models chosen and taken by their parents and guardians. Indeed, the development of a child involves aspects such as pedagogical development and the development of the various biological systems in the body.
The whole process is geared towards achieving total autonomy in the child. Children are exposed to many issues at an infant age. The most challenging of these issues is the introduction of new diet. Children often have to begin feeding on supplementary diet that is different from mammary milk after they attain the age of twelve months. Child development policies and strategies ensure that these steps and stages in the development of the child are done incrementally and professionally to achieve desired impact (Bevans, Riley & Forrest, 2010).
Background on child development
Child development has been a source of scientific and medical research over the last few decades. Policies in child development often relate to the ability of the parent to help them achieve autonomy. However, with regard to theories in child development, the concern has often been about the emotional and physical relationship of the child and the mother. Many studies have been done on issues in child development. They have since resulted in aspects of child treatment, immunization and even nutrition.
The most significant theories in child development are the Developmental theories and the attachment theories (Warner, 2007). It is necessary however to realize that although most of the theories on child development have hardly been refuted, they have not been unanimously approved as well. Child development is often the cause of controversy in many policy development forums. There are particular goals that need to be achieved in child development but many different approaches to achieve these theories.
Where child development in a biological context is concerned, the physical change in the body of a child as they move from childhood to puberty is often a marvel in scientific research. Many children often realize a particular affinity for certain objects, games and pleasantries as they grow. However, there is likely that a child’s growth potential is achieved by the time they reach puberty (Bevans, Riley & Forrest, 2010). Children however do not easily learn the psychomotor skills on their own.
The exposure the child gets as they grow often determines how well they grow with regard to psychological and emotional development. There is indeed a direct relationship between the child’s environment and their eventual personality traits. More so, the adaptability of the child at the infancy stage is higher than at any other stages in their development. This is why child development theory and practice takes center stage among many pediatric research and education practices (Capel, 2012).
Child development however exceeds past growth. For instance, when a child grows, organs do not just grow, they are specialized. The same is the case for the various body cells and senses. They become bigger (grow) and better at their functions (develop). Child development theories thus take all these issues into account. However, with regard to the aspects and determining factors in child development; it is often the case that cases of child development complications are often treatable.
Medical research asserts that since the mind of the child keeps changing and growing, it is often the case that children may outgrow behavioral and psychological issues. There is however contention on the possibility of child brain research towards the treatment of regressive growth involving limbs and other bodily organs with a rich nervous system (O’Connor & McCartney, 2007).
Child Development Theories
Child development theories assess the growth and development of the child; the mitigating factors and the various aspects of the growth. Theories try and explain why phenomena such as development of limbs, ability to walk, talk and read as well as the growth of the intuition in a child occurs as it does. The major categories children are classified into often include; newborns, infants, toddlers, preschoolers, school-aged children and adolescents. These different categories of children often exhibit different traits.
This is why models are often specific to the category and explain how growth takes place from one category to the next. There are various theories formulated towards contributing to child development policies. However, this paper will discuss two main theories; child development theories and child attachment theories. These theories help scientists assess various growth factors and inhibitors to proper development of the child (Rigby, 2007).
Child development theories assess and explain the factors behind a child’s development. The most common of these theories is the ecological systems theory. The ecological systems theory was first proposed by Urie Bronfenbrenner. He proposed four categories for child biological development. These include; microsystem, mesosystem, exosystem and macrosystem. The microsystem of the child is the nervous and cardio vascular system. The mesosystem defines the muscular system in the body.
The exosystem defines the skin organ of the body and all systems that interact with the external environment while the macrosystem defines the organ system in the body. A child’s development is expected to take place simultaneously in all these four stages. The theory also proposes that each of these subsystems contains particular norms and principles that guarantee development in a symbiotic manner. The relationship between the systems defines how well or retarded growth in a child is.
The child attachment theory defines the psychological, evolutionary and ethological development of a child. The theory asserts that interpersonal relationships between human beings are based on the development and proliferation of psychological needs. These needs stem from the child’s emotional upbringing and contact with the environment they live in. It is thus a concern that needs to be addressed by care givers.
The child’s evolutionary needs have to do with the child’s nutrition and socialization. Aspects such as early schooling, introduction to sporting activities and involvement in household chores contribute greatly to child development. It is thus critical to achieve these early. However, ethological (behavioral) growth in a child is cultured from the observations the children make on their own. This is why the environment one raises a child in must be protected from unnecessary exposure.
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Early Childhood Education Theories
Early childhood education theories discuss the development of the child as they progress through school from introduction to later stages in school. For instance; the Development Integration Approach in child development discusses child development on aspects such as; physical, social, emotional, language and cognitive skills. Physical development is assessed through measures such as the body mass index (BMI) that evaluates the mass against the height of the child. Social and emotional development skills are the skills the child acquires from interacting with other children and adults.
Language can be considered in two aspects; the first language the child was exposed to; known as L1 and the other languages follow as L2, L3…However, language can also be the ability of the child to learn etiquette, euphemism and other necessary language skills at an early age. Cognition in a child is the most observable change. Abilities such as reading, learning and concentrating however take time to develop in a child. The ability to use language properly is very important to the child’s growth as it makes them able to communicate (Warner, 2007).
The other common theory in early childhood education is the socio-cultural learning theory. This theory asserts that the impact of the child’s social experiences as well as their cultural disposition affects their individual thinking and the development of their mental processes. This is why it is important to raise children in environments that elicit such growth potential.
All the same, whatever environment the child finds themselves in is able to affect their mental and psychological health either positively or negatively. The theory by Lev Vygotsky proposes that cognition should be trained by the child’s care givers since it occurs on a social context. Allowing children to play and undertake certain responsibilities early prepares them for such responsibilities in the future (O’Connor & McCartney, 2007).
For instance, early driving classes make the child develop an intuitive sense that helps them discern the path to take while on the road and the decisions that can help them avoid accidents and dangerous driving. Socio-cultural learning also presents the argument that a child born in cultural practices will likely learn them and embrace them early if they are exposed to them from the onset.
Conclusion
Early childhood development is a phenomenon that has been observed by scientists across the world for centuries. Indeed, aspects of child development such as the development of psychomotor skills, cognitive development and physical development often relate to the child’s culturalization. Most care givers are advised to monitor the path through which the child takes in their development actualization pattern in order to grow into the anticipated adults society envisions.
However, there are biological factors in child development and growth that do not really have anything to do with the care givers but actual parents. Genetic factors are often difficult to deal with as they are as the result of recessive genes since childhood. In such cases that these recessive genes lead to visible impaired limbs, it is necessary to seek medical attention to know how to handle these cases (Ogunnaike, 2015). Children should always be brought up in environments where they feel safe and able to interact freely with all persons in their vicinity. Since most of what they learn is acquired from vision, it is important to invest on the child’s environment and control it as much as possible without interfering with it.
References
Bevans, K. B., Riley, A. W., & Forrest, C. B. (2010). Development of the healthy pathways child-report scales. Quality of Life Research, 19(8), 1195-214.
Capel, C. M. (2012). Mindlessness/mindfulness, classroom practices and quality of early childhood education. The International Journal of Quality & Reliability Management, 29(6), 666-680.
Rigby, E. (2007). Same policy area, different politics: How characteristics of policy tools alter the determinants of early childhood education policy. Policy Studies Journal, 35(4), 653-669.
O’Connor, E., & McCartney, K. (2007). Examining teacher-child relationships and achievement as part of an ecological model of development. American Educational Research Journal, 44(2), 340-369.
Ogunnaike, Y. A. (2015). Early Childhood Education and Human Factor: Connecting Theories and Perspectives. Review Of Human Factor Studies, 21(1), 9-26.
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OBESITY: Community Health and Population focused Nursing
Identify a community for which there is data available that will support the diagnosis
The county is located in Pennsyltucky-in the northern region of the State. The region is mountainous and is characterized by stone mining industry. The region experiences warm and humid summer and heavy instant snow falls during winter. The region lies in York County. The region has diverse ethnic community owing to the large immigration of people from Gotham city. The community assessed was my county state which was among was one of the hardest hit by the 1919 influenza pandemic. Since then, the State has established adequate measures to ensure that such incidences do not occur again.
The main non-communicable health problem identified in this region is obesity. Obesity has serious consequences on the residents of this county’s health as well as the economy. This is because obesity is associated with a number of chronic health complications such as stroke, diabetes, cancer, and coronary heart disease. In the USA, obesity accounts for 147 billion dollars of the total health cost. Most people in this county are have adopted unhealthy lifestyles such as poor diet and physical inactiveness (CDC, 2016).
B. Health needs assessments
Population Economic Status
The demographic data released by the Census Bureau in, York County has a population of 438,052. The county reports 0.7% of the population change. The population density is estimated to be 484 per square meter. The median age is reported to be 40.6. Approximately, 70% of the populations are in the family. The unemployed in this region is about 4.7%. The employment growth rate is less than 1%. The income per capita in this community is estimated to be $ 27,996 (York County PA, 2016).
Disaster Assessment and Planning
The County is prepared for management of disasters. The York County office of Emergency Management (EOM) is responsible for the Emergency management program. The mission of the office is to protect the community by integrating necessary activities that sustain and improve their ability to mitigate, prepare and respond to the threatened natural disasters they ensure that the community are notified of emergency situation (York County PA, 2016).
Neighborhood/Community Safety Inventory
The main risk of concern of the County is caves and sinkholes and the severe winters which make it not favorable for the outdoor activities (York County PA, 2016).
Cultural Assessment
The culture and history of this county is unmatched in the country. The area is neighbored by super historic sites with an impressive ethnic population. The big cities in the county comprises of Italian, Irish, Chines among other immigrant communities. This is complemented by the rural lifestyles where most of the people in the mix of Amish which adds wild austerity to the culture (York County PA, 2016).
Windshield Survey
The homes are mainly detached and well maintained. The in-town homes yards are smaller as compared to township hopes. The roads are generally is in good condition to serve the business in the region. The main health concerns are that some roads are busier which an issue for physical activities such as cycling and walking along the path. This is due to the inadequate maintenance of the pedestrian paths, which can be used by the community to walk or cycle to their work places.
There are also high reports of injuries associated with car accidents. The parks are poorly maintained and I noticed several sink holes that have not been covered. This is makes it difficult for the residents to engage in outdoor activities. In addition, there are fewer green grocery shops. Therefore, most of the residents rely on fast foods because they are cheap and easily available. There is a big contrast of York County, Pa when compared with the neighboring counties as they have a nice climate and environment place to work and live.
SCAVENGER HUNT
The following six facilities were explored, Health department, YMCA, Fire department, American Red Cross, National Alliance on Mental illness, and community Center. The public health departments include Health department. This organizations target the residents of York County Community. The facilities advertise themselves through public facilities such as health centers and educational facilities. The main barriers observed are inadequate medical cover and Language barriers.
There is no service fee as these services are funded by the Local government. The staffs in these facilities are welcoming and very respectful. They are always ready to help. The main issue I observed is language barrier. Only few of the staff could speak other languages fluently, which makes it difficult for them to communicate with Non- English speaking residents. The organizations operate in both referrals and self-referrals process. The organization has details in internet and any person can access information from any location (Health York County, 2015).
American Red Cross this organizations target the residents of Central Pennsylvania. It serves 22 counties including the York County Community. The facilities advertise themselves through public facilities and the internet. It offers relief during pandemic and also facilitates blood donation processes. There are no barriers I observed in this organization as it helps every person of the society.
This organization obtains its funds from the Federal government. It is actively involved during natural disasters of disease pandemic. In fact, the organization responded to 520 disasters in the Central Pennsylvania region, where it helped 803 local families who had been affected by disaster. There is no service fee required for one to obtain help from this organization as it is funded by government and international bodies. Most of the staff I interacted with were respectful and had positive attitude.
In addition, the organization has five staff members who could speak other languages fluently, which makes it easy for them to communicate with Non- English speaking residents during disaster. The organizations operate in both referrals and self-referrals process. The organization has all contact details in internet (its website) and any person can access information from any location (Health York County, 2015).
NAMI York County branch offers support to people with mental illness in York County. The group offers support connection group that meets weekly and monthly. They also offer peer to peer and family to family education program that focusses on wellness, recovery and mental health. The facilities advertise themselves through public facilities such as health centers and educational facilities. The main barriers observed low awareness of the program in the community.
According to the director, most people in this community will not bring their loved ones to the organization because they fear discrimination. There is no service fee as these services are funded by the Local government, yet only a small fraction of the community enjoys the services. The staffs in these facilities are understanding, respectful and are always willing to help. Only few of the staff could speak other languages fluently, which makes it difficult for them to communicate with Non- English speaking residents or the deaf and dump. The organizations operate in both referrals and self-referrals process (Health York County, 2015).
The YMCA organizations target the residents of York County Community. This program offers health and fitness knowledge. The organizations operate in both referrals and self-referrals process. The organization works with people of all interests, abilities and ages. The organization tailors the programs content to suit the client needs. The facilities advertise themselves through its website.
The main barriers observed are that the organization charges $30-$49 for membership. This implies that large fractions of the population are locked out from experiencing these services. Language barriers are also an issue. Only few of the staff could speak other languages fluently, which makes it difficult for them to communicate with Non- English speaking residents. The staffs in these facilities are respectful, but tend to favor members from high income household.
Fire department provides professional, effective and courteous emergency response in order to protect the lives of York County residents as well as their visitors. The organization takes every effort to reduce the risk of the people residing in the community by preventing fire incidences through education and risk assessment of fire investigation. The department comprises of 56 personnel, one civilian employee and over 45 volunteers. There is no membership fee as it is funded by the federal government. The organization works mainly through referrals and self-referrals (Health York County, 2015).
Community center main role is health promotion of the York county residents. They do so by promoting various activities that people learn more about physical activity and good nutrition. They organize school based tournament and cultural weeks from which the community actively participate. However, only few community centers are operational so far. For this reason, most people in the rural areas rely on alternative medicines, and pregnant mothers deliver with the assistance of the house wives (Health York County, 2015).
Provide a logical interpretation of the collected data using concepts of epidemiology
York County is one of the most obese counties in the UDA. The current obesity rates in this county are approximately 31%. This indicates that approximately a quarter of the residents are obese. According to the distributed sources, the normal aggregate costs identified with the visits particularly to the obesity related outpatient and inpatient visits are estimated to be US$ 156 and US$ 1,512 respectively. Direct medicinal costs are estimated to be 45%-70% of the aggregate expenses linked to the obesity outpatient and inpatient visits. There are minimal reports with regards to the mortality and morbidity rates among the population in relation to obesity and its associated health complication (Health York County, 2015).
Identify any problems based on the Healthy People 2020 goals for the selected community.
In view of Healthy individuals 2020, there are problems affecting the selected community. These problems include lack of physical and social environments that facilitates promotion of good health, lack of adequate frameworks that will promote the development of healthy behaviors which aims at improving the residents quality of life and there lacks strategies that adequately help achieve health equity in this community implying that no measures have been successful in eliminating health disparities (Health York County, 2015).
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Provide a logical discussion of the problems in relation to the Healthy People 2020 goals
Arguably, York County is one of the weak links of global preparedness with regards to the management of obesity and associated chronic health complication. To begin with, there is no transparency in acknowledging the burden of obesity in the community. In addition, the public healthcare system has failed to establish systems that will ensure elimination of health disparities in the region. York County is one of the Counties in which obesity rates among the low income household is continuing to rise. The behavioral risk indicator indicates that the residents in this community hardly exercise. Only a third of the populations eat three servings of vegetables each day. The data also indicates that one in five people in the community are smoke (Healthy People 2020, n.d.).
Research findings indicate that two in every three people are obese. The rates of other chronic condition are such as cardiovascular disease, cancer, and diabetes also comparatively high. In addition, one in every five people in this community is diagnosed with depressive disorder and anxiety. Consequently, this has a negative impact on the Healthy People 2020 strategies whose main aim is to realize longer lives that are free from preventable diseases, elimination of health disparities, and creation of safe social and physical environments that promote good health and behavior of the healthy people (Healthy People 2020, n.d.).
Provide a logical discussion of community resources that are available to address the selected problem
CDC ACHIEVE Program
Community resources such as CDC ACHIEVE Program give valuable information effective strategies to manage obesity and its associated disorders. As mentioned therein above, people who are at risk of being obese infants, elderly, people suffering from chronic diseases, and pregnant women due to aggravating factors such as poverty and lack of physical activeness. This institution helps to increase awareness of the role of proper nutrition and physical activeness in eradicating obesity and its associated complication.
The strategies include funding the local governments to give them support to improve amenities including Heritage Rail Trail County Park, walking paths and bike routes. This aims at giving the pedestrians access to activities that will improve their health. The program also works with the other stakeholders including schools facility which plays a critical role in school food based programs. Other stakeholders involved includes fitness based programs and organization such as YMCA and YWCA. This helps the community to understand their perceived threats as well as the preventive measures that must be undertaken (Payne et al. 2013).
CDC ACHIEVE Program also helps the National Societies to play a leading role in managing the effects of the pandemic. This is facilitated through the close connection to communities and their auxiliary role to the governments through a measure commonly referred to as “Eat Play Breathe York”. This improves delivery of preventive services such as personal protective clothing during the outbreak, procurements and dispatchment of disinfectants, creating awareness sessions at school level (CDC, 2015).
Provide a logical primary prevention topic based on the problem identified in part C2.
Effective treatment of obesity begins with change in a person’s lifestyle. The obese person is expected to self-monitor the calorie intake and physical activities. This is achieved through effective goal setting and ensuring that they avoid factors that would lead to relapse of the old unhealthy habits. Effective management requires highly motivated patient and committed healthcare professionals including dieticians, physical therapists, psychologists and other subspecialists (Payne et al. 2013).
Behavior modification that targets diet and exercise must be included in all obesity management strategies for individuals whose BMI is above 25 kg/m2. Pharmacotherapy strategies are recommended for people whose BMI is above 27 kg/m2. Bariatric surgery is recommended for individuals who have BMI between 30 kg/m2 and 35 kg/m2. In dietary behavioral changes, people are advised to eat low calorie diets and practice portion control of the diets. Most of the diets underlie the weight programs guidelines such as those advocated by Jenny Craig and Weight watchers. The basic premise involves ensuring that the person obtain detailed dietary inventory which is normally used to estimate their caloric intake (CDC, 2015).
It has also been hypothesized that taking water before each meal facilitates weigh loss in obese middle aged people. This is associated to increase in resting energy due to water induced.
Physical activeness is recommended as it is effective for patients with cardiovascular disorder and respiratory health issues. Exercises are important because they help burn the excess body fat. For effective observation, people are encouraged to have moderate exercises continuously in order to achieve the effective weight loss. Research indicates that shorter bouts of physical activeness have better outcomes (Health York County, 2015).
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Clinical Quality: Patient Customer Service Quality
The clinical quality and the customer service quality which brings about the patient experience is used in the evaluation of the type of healthcare provided to the patients. The patient experience that results from the type of health care received is an essential outcome that is linked with the organization quality which is relevant when it comes to the management and assessment of care (Ahmad et al, 2015).
Despite the relationship between customer service quality and clinical quality, there exist some differences that are brought about by various factors. These factors include poor communication affecting the compliance to treatment, poor standards of care and also poor access to services for the customers which affect the provision of Medicare (Amin et al, 2013). The increased aspect of clinical quality is bound to deteriorate the patient-centered care which is enhanced by enhancing quality customer services.
The lack of satisfaction of the services offered at the health centers has prompted the customers to file complaints related to allegations of poor quality care, mistreatment, abuse and also neglect by the care providers. The East view health Centre is one medical nursing home that has received such complaints from the customers. The nursing home is located in the Birmingham has a 59% occupancy rate.
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The health Centre has a bed capacity of 112 beds occupied by the patients. The health Centre is part of the multiple nursing homes ownership under the for-profit corporation (Ihle et al, 2016). The complaints that are reported by the customers are attributed to the challenges and problems experienced in the center. All challenges and problems are closely related to the delivery of care to the patients.
The issue of protecting the patients from misappropriation of personal property, neglect and also mistreatment is highlighted as one of the complaints reported. The complaint relating to the provision of healthcare by the qualified practitioners to each of the patient’s written care plan. The issue of the provision of adequate supervision to reduce the cases of accidents and other health related hazards in the nursing home is also filed as a complaint received from the customers (Ihle et al, 2016).
There are various customer service quality and quality clinical operations that take place in the health Centre. Some of the customer services offered at the health Centre include social work services, therapy services, activities services and physician services among other many. The nurses in the health centers offer services that aim at ensuring the patients are safe and included in the treatment planning process which enhances the patient-centered care for the satisfaction of the customers (Ahmad et al, 2015).
The center also provides care and treatment to patients to reduce the cases of injuries healing the existing bed sores and also prevention of the new bed pressure. The nursing facilities are provided to the patients in the health Centre where the services are expected to be quality with cleanliness and visual appealing facilities. There has been questions and issues about the service quality in the health Centre, which influences the patient’s satisfaction and perception about the nursing home.
The problems and complaints reported by the patients fault some of the quality customer services offered by the health Centre. In this case, the quality is not given full credit for its services. Misappropriations and mistreatment of the patient are some of the complaints relating to customer services that show some inefficiencies (Ihle et al, 2016).
The customer service quality when it comes to staffing and the timely delivery of care indicates lower quality of care as per the expectations of the patients. The have been complaints about the satisfaction of the patients as per the services they received in the nursing home. There are mental health services, as well as other therapy services offered by the nursing home, has been faulted by the complaints relating to the maintenance and recognition of the individuality of the patients. The patients respect the practitioners to ensure their dignity and respect is fully upheld to enhance a good nurse-patient relationship and satisfaction to quality of care provided.
The clinical quality refers to the accuracy of the procedures and diagnosis tasks carried out by the care providers to the patients (Ihle et al, 2016). The East view health Centre has tried to ensure that the quality of care is offered as per the professional specifications. Special attentions should be on delivering service quality. The health Centre has made efforts aimed at prevention of the infections in the health Centre and also enhancing the proper mechanisms that control the spreading of the infections (Burwell, 2015).
However, there has been complaints relating to the efforts by the nursing home to ensure efficient control of infections and prevention of diseases and injuries which indicates some improvements need to be done to ensure the clinical quality of all operations. The East view health center has effectively kept organized, accurate and complete records for its patients as per the professional standards set.
The availability of qualified professionals that provide care by the written care plan of the patients has led to complaints about the clinical quality in the health Centre. By the inspection results the nursing home is expected to improve their care operations for the patients requiring special services to ensure clinical quality. These services include respiratory care, tracheostomy care, injections and prostheses among other many offered to the patients. Recommendations by the inspection unit to improve on the safety measures is an indicator of the substandard quality care that needs the remedy (Burwell, 2015).
There are various techniques that can be adopted to improve the clinical care and customer service quality in the health Centre. Proposing the implementation and adherence to the patient-centered type of care is one of the techniques that would seek to improve the quality of customer service care at the health Centre. The technique seeks to address issues such as delays of care and lack of full involvement in the treatment plans which highlight some of the complaints reported at East view center.
Training the healthcare providers and offering the technical assistance as well as providing the evidence-based recommendations is a key technique in enhancing them to provide the quality customer service care to the patients. The technique of ensuring inspection to take disciplinary measures for those mistreating the patients and neglecting them to the extent of offering substandard care is vital to improving the quality of the customer service care (Amin et al, 2013). Adoption of these techniques effectively addresses the complaints and the problems that hinder quality services to the customers.
The quality clinical care in the nursing care requires some improvement to ensure the services are offered as per the professional specifications. The shape up of the administration and the staff to enhance the coordination between healthcare providers through the formation of teams which leads to cooperation is a technique that improves clinical care in the nursing home (Ahmad et al, 2015). The technique ensures they care to work together to meet the standards of quality care.
Appointing an internal inspection to identify regularly the areas that need some quality improvement is an important technique that enhances improved clinical care quality. Ensuring the integrated health services and designing a program that controls, investigated and manages infections in the nursing home is an efficient technique in ensuring the improved quality of clinical care. The effective adoption and implementation of the techniques lead to the overall improvement in the quality of care offered in the East view health center.
Ahmad, A., Nurhanis Syazni, R., Jamilah Al-Muhammady, M., & Muhamad Saiful Bahri, Y. (2015). Medical Graduates’ Perception on the Quality of Clinical Education. Education In Medicine Journal, 7(4), e52-e59. doi:10.5959/eimj.v7i4.401
Amin, M., & Zahora Nasharuddin, S. (2013). Hospital service quality and its effects on patient satisfaction and behavioural intention. Clinical Governance: An International Journal, 18(3), 238-254.
Burwell, S. M. (2015). Setting value-based payment goals—HHS efforts to improve US health care. N Engl J Med, 372(10), 897-899.
Ihle, C., Ateschrang, A., Grünwald, L., Stöckle, U., Saier, T., & Schröter, S. (2016). Health-related quality of life and clinical outcomes following medial open wedge high tibial osteotomy: a prospective study. BMC Musculoskeletal Disorders, 171-11. doi:10.1186/s12891-016-1076-x
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