Analysis Of Data-centered And Driven Society History Assignment Help Writing Services

Considerations to make before buying home insurance apus history essay help: apus history essay help

Regardless of whether you live in the most secure location in Missouri or have invested in the best security systems, your home is really never entirely safe. Think about natural disasters like storms, earthquakes, and sometimes fire. Think about accidents in your home like people slipping and falling, getting bitten by your pets, getting hit by an object. Are you financially prepared to handle these accidents whenever they happen? No? Then you need a home insurance policy, and Travers Insurance can help you acquire one.

Considerations to make before buying home insurance

If you have decided to purchase home insurance, you have to critically think about the kind of perils you want to be covered and which accidents are more relevant to you. If you live in a flood zone area, make sure you buy a flood insurance policy because home insurance in Missouri does not cover floods. Some of the things to think about when purchasing insurance include:

Where your home is located ( if it is a safe neighborhood, the cost of insurance will be lower, if your home is near the coast, the price is likely to be higher)
The size of your home. Bigger houses command more coverage ( features such as a swimming pool and a home office increases your premium rates.
The number of people living in your home including pets( if you have teenagers or small children in the house, the cost can be higher than a home with older people)
How much you have invested in securing your home. ( if your home has reinforced security, it means it is partly safe from burglaries which lower the chances of filing a theft claim.

What is covered by a standard home insurance policy

Home insurance is an all-round policy that provides coverage to damaged property and liability and legal responsibility for property damage and. It doesn’t matter whether you are a Webster Groves MO or St Louis MO resident, home insurance in Missouri is the same everywhere. Some of the coverages include:

Dwelling coverage
Other structures coverage
Liability coverage
Personal belongings coverage
Loss of use

Feel free to visit Travers Insurance for all your home’s insurance needs, and we will be happy to help.

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History of Philanthropy ap world history homework help

History of Philanthropy

Introduction

The phrase “philanthropy” stems from the Greek word “philanthropia,” which means “loving people (Croucher, 2017).” In the modern age, the practice of philanthropy is inclusive of voluntary giving by either groups or individuals, all for promoting the common good. Also, it covers the formal act of making grants to nonprofit organizations (Barman, 2017). Today, philanthropy serves the purpose of improving the welfare of humankind and solving societal issues. The difference between charity and philanthropy is that the former focuses on eradicating suffering caused by social problems, while the latter aims at destroying the issues completely. This paper provides an overview of the history of philanthropy in the U.S. and the globe, citing its origins and popularity in social and cultural dynamics. Further, it evaluates the major players in philanthropic activities and highlights the contribution of philanthropic figures in U.S. history.

Overview

Philanthropy dates back thousands of years, and it was traditionally practiced for varying reasons. Some individuals used the practice to promote the common good, while for others, it was a route to fame, recognition, and power. In medieval times, Chinese families provided finances to the unprivileged in society, including orphans, widows, and elderly persons. Likewise, in the Bible, the Hebrews offered one-tenth of their gain to God and the needy in the community. Egyptian rulers also gave back to society to appease the gods and to secure a good afterlife. Over the centuries, religious beliefs have changed people’s perception of the practice of philanthropy. Religious system influence help to define what can be regarded as “moral.” Therefore, it’s necessary to note that religion has played an integral role in defining philanthropy in both traditional and modern societies.

In the U.S., Native Americans were the first philanthropists, and they were primarily motivated by the concern for the common good. The arrival of Europeans triggered the philanthropic traits of the Native communities as they handed the former equipment and knowledge required for survival. The colonization of America also expanded the practice, as Europeans expanded their interest in religion, charity, and giving back to society. European philanthropists provided Americans with education, schools, and “civilization” centers. Before the mid-19th century, philanthropic activities in the U.S were solely driven by religion and morality. Events like the “Great Awakening” in the 18th century encouraged individualism and blemished the power and influence of churches (Quirion, 2015). Consequently, Americans began practicing philanthropy outside church domains, which popularized philanthropy in all levels of society.

At the end of the Civil War, the practices of charity and philanthropy had grown rapidly. Reformers opted to develop philanthropy as a science to help streamline patterns of giving. They associated the new dynamics with Social Darwinism, which maintains that social problems stemmed from an innate inability of the poor to be successful. Therefore, charity reformers advocated for a new system where the poor were supervised closely to improve their lives. The post-civil war period left a significant portion of Americans so rich that they couldn’t exhaust their finances. Figures John D. Rockefeller has a strong sense of charity, and they created foundations to manage their vast wealth. The act was a defining moment for philanthropy in the U.S, as it encouraged the integration of professionalism.

Major Players

Since its inception, philanthropy has been mostly practiced by leaders, organizations, wealthy individuals, and prominent families in society (Croucher, 2017). In Asia, wealthy Chinese families provided financial aid to the poor and elderly in the community. Likewise, Egyptian Pharaohs gave back to society, but their motives were relatively more selfish. They participated in philanthropy to appease their gods and to secure a happy afterlife. In ancient U.S. society, figures like John D. Rockefeller and Andrew Carnegie brought a new age of professionalism in philanthropy, by setting up charity foundations that are still active.

Today, figures like Bill Gates, Warren Buffett, and Azim Premji are amongst the most philanthropic individuals on the globe. Over the years, they have provided grants to various sectors around the globe, including healthcare, sanitation, education, and disease prevention. Further, most wealthy individuals extend their helping hand by setting up philanthropic foundations, which have a greater reach to needy communities. Private organizations continue to grow their philanthropic activity globally, and their grants are growing in importance by the day. The Bill and Melinda Gates Foundation, Open Society Foundations, and Ford Foundation are amongst the most philanthropic organizations globally.

Carnegie and Rockefeller

The philanthropic activities of Andrew Carnegie and John D. Rockefeller remain to be the most captivating events of the modern age. Unlike modern figures, who might be driven to philanthropy by societal expectations, Carnegie and Rockefeller had a natural and innate urge to give back to society. For instance, Carnegie believed that a wealthy man’s life comprised of two phases; gaining riches and using the wealth to improve the wellbeing of society. True to his word, at the peak of his apogee, Carnegie established the Carnegie Institute and became known as the “patron saint of libraries (Carnegie Corporation, 2016).” Likewise, at the downfall of Standard Oil, Rockefeller set up charitable institutes, where he gave away a huge slice of his vast wealth. Despite probable differences in motives, both Carnegie and Rockefeller birthed a dynasty of philanthropy that extends to the present day.

Reflection

Philanthropy is and will continue being an integral component of a democratic society. Technically, the practice is distinct from charity as it focuses primarily on eradicating challenges in society. I have an unending passion for fundraising and philanthropy as they support projects like libraries and scientific research, which benefit different communities and the globe at large. Further, philanthropic efforts support endeavors that could be considered too controversial to be supported by governments or the general public. Philanthropy is essential in a democratic society as it provides numerous opportunities and voices the needs of minorities and the disadvantaged in society. Despite the absence of vast wealth at the moment, I aspire to donate and improve the wellbeing of society and join the philanthropic sector. Today, technology provides new platforms and means of fundraising, which makes it easy to reach communities and donors.

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Asthma Disease Process gcse history essay help: gcse history essay help

Asthma Disease Process

Investigative Disease Process

Asthma is a chronic illness affecting the air passages in the lungs. The condition causes the air-carrying tubes to be inflamed and narrowed on certain occasions (NIH, 2020). Moreover, asthma affects individuals from all age groups and manifest from childhood. Wheezing, coughing, and a feeling of tightness in the chest are some of the symptoms that patients may display and ranges from mild to severe (Bush, 2019). The symptoms may be experienced regularly or once over a long period. Understanding the various components to the diseases due to the large number of people it affects. According to the World Health Organization, more than 339 million individuals had asthma in 2016 all across the globe (WHO, 2020). Moreover, an estimated 417,918 deaths were attributed to the disease making it necessary to investigate and develop a clear understanding of the non-communicable disease especially regarding its management for the improvement of quality of life among affected individuals.

A1. Pathophysiology

Asthma is a long-term disease that affects millions of people across the globe. The pathophysiology of the condition is complex as it encompasses airway inflammation, intermittent airflow obstruction, and bronchial hyper-responsiveness (Morris, 2019). Asthma primarily affects the lungs, wherein normal respiratory physiology; lungs can expand and return to their relaxing state. In asthmatic conditions, the physiological mechanisms change due to inflammation that decreases the area of the air-carrying pathways. These mechanisms combined to alter the responsiveness of the lungs slightly increasing the work of breathing (Sinyor & Perez, 2019).

Asthma exacerbation occurs in two phases. The early stage is instigated by Immunoglobulin E antibodies that are alerted and released by plasma cells. These antibodies react to specific environmental triggers that then bind to high-affinity mast cells and basophils. When an impurity or risk factors are breathed in, the mast cells discharge cytokines and immediately degranulate. Mast cells release histamine, prostaglandins, and leukotrienes. These cells, consequently contract the smooth muscle and lead to tightening of the airway. Th2 lymphocytes, on the other hand, produce a series of interleukins and GM-CSF that aid communication with other cells to maintain inflammation. The later stage happens after a couple of hours. It is characterized by eosinophils, basophils, neutrophils, and helper and memory T-cells all localizing to the lungs, which causes bronchoconstriction and inflammation. Mast cells also transport reactants to the exacerbated sites (Sinyor & Perez, 2019).

A2. Standard of Practice

In assessing and diagnosing asthma, physicians often discuss medical history with the patient. Moreover, it is necessary to undertake a physical examination which may require lung function tests and chest X-ray (AAFA, 2015). In assessing the personal and medical history regarding asthma, the focus is set on physical problems whereby the display of shortness of breath, wheezing, coughing, and tightness in the chest may indicate the presence of disease in the patient. Also, the physical exam entails the doctors checking the ears, eyes, nose, throat, skin, chest, and lungs of the patients to examine how one exhales air from the lungs.

The lung function tests measure the breathing of an individual and are undertaken before and after the inhalation of a drug referred to as bronchodilator. The inhaled medicine is purposed to open the air passages of an individual, and if there is a significant improvement in lung function from the use of the drug, then one probably has asthma. In clinical practice, the most adopted lung function tests for asthma diagnosis include spirometry, peak airflow, FeNo tests, and provocation tests (AAFA, 2015).

In the spirometry test for asthma, a person blows into a machine that is set to measure the rate of breathing out and the quantity of air that can be held in the lungs. For the FeNo test, an individual breathes into a machine designed to measure the level of nitric oxide in the breath which often signifies inflammation in the lungs. In peak flow tests, a handheld instrument is breathed into to measure the ease of air to move out of the lungs (AAFA, 2015). Moreover, the provocation test assesses the sensitivity of the lungs when exposed to triggers such as perfumes or smoke, exercises, and drugs.

Managing asthma is done through treatment by administering various medication such as anti-inflammatory medicines and bronchodilator medicines. Anti-inflammatory drugs are purposed for the treatment of the underlying medicine, whereas bronchodilator medicines are administered to relieve the symptoms of the condition and airflow limitation. Managing asthma is usually focused on the prevention of symptoms, minimization of morbidity from severe episodes, and the prevention of functional and psychological morbidity for the provision of a healthy lifestyle (Morris, 2019).

A2a. Pharmacological Treatments

Asthma management is recognized as a heterogeneous condition with different phenotypes and causal mechanisms (Reddel, 2018). Although asthma is incurable, it can be controlled with appropriate medication and self-management. The most commonly used therapies are immunizations, such as pneumococcal and annual influenza vaccines (Centers for Disease Control and Prevention, 2017). Other pharmacological treatments include the inhaled corticosteroids (ICSs) (Janson et al. 2019). Despite the various medications, reports have shown that asthma is not controlled in a large percentage of patients hence impacting on their quality of life, affecting the patients’ sleep, and causing significant economic burden to society.

Allergy medications

The most commonly used therapies are allergy injections such as Fasenra which attacks the eosinophils in the body by decreasing the body’s IgE levels in people with severe asthma. These injections can be administered at the physician’s office or through self-injection after a demonstration by the nurse on the appropriate techniques of administration. The medications are administered every month for the first three months starting with the first day of the appointment, and then every two months after that. Dupixent is another allergy injection that is administered sub-Q the first initial dose is doubled then every two weeks. Dupixent targets eosinophils in the body and is beneficial in managing patients with moderate to severe asthma.

Fast-acting medications

Medications include bronchodilators which work to open the air passages by relaxing the smooth muscles. The drugs make it easier for patients to breath properly and more efficiently. The treatment approaches are also called rescue medications and include duo-neb, Proventil, max air and accuneb, which can be inhaled via nebulizer treatments, and oral inhaler such as Ventolin. Solu Medrol given IV route is a steroid that decreases the inflammation around the bronchial tubes, making it easier to breathe this may be provided through the mouth and on a tapering dose level. Vital side effects may arise if the medication is stopped abruptly. Moreover, oral medications known as Prednisone can be used as an anti-inflammatory drug to aid in the easement of breathing in patients. Prednisone is a glucocorticosteroid as it enhances anti-inflammatory actions; hence blood sugars may need to be monitored while on this medication. Epinephrine is also used in severe asthmatic patients that have status Asthmaticus and is used to provide fast relief in patients who are having mild to severe asthma attacks. Duo nebs is a combination of Ipratropium and albuterol mixed are used to treat acute asthma attacks and lung disease.

Long term medications

These are medications that are used to control aggressive asthma over the long-term and are taken daily. Several different controlled meds can be given such as powder inhaled steroids Breo eliptica, Advair diskus there long-acting corticosteroids and should not be used as a rescue inhaler.

Leukotrienes can be given orally and are used to block chemicals that cause the air pathways to constrict. These drugs may include montelukast sodium, zafirlukast, and zileuton which provide individuals living with asthma protection for the whole day.

Theophylline is a second line of defense drug and is an older drug used as a bronchodilator for asthmatics, COPD, and other respiratory issues. It functions to relax the smooth muscles and relieves chest tightness making it easier to breathe, theophylline levels are drawn to make sure the levels are between 5-15mcg/ml for older adults and children 5-10mcg/ml, it can be conjoined with beta-agonist when the first line of defense drugs are not working properly.

Long-acting beta-agonists (LABAs) such as salmeterol and formoterol are and essential treatment for asthmatics, especially when taken with an inhaled corticosteroid (Li, 2019). LABAs are administered in a scheduled manner purposed for the opening of constricted air paths and prevention of asthma episodes. It is necessary to take LABA with inhaled corticosteroid since LABAs have been associated with vicious asthma attacks (Li, 2019).

Mast cell stabilizers

These inhalants are used for mild asthmatics, and it helps by decreasing the asthma symptoms when exercising or when exposed to substances that can potentially trigger an asthma episode. The stabilizers help to inhibit mast cells from releasing the components that lead to inflammation hence could reduce the occurrence of asthma symptoms. However, mast cell stabilizers may not be helpful in individuals with moderate to severe asthma as they do not function as well as corticosteroids (Healthwise, 2014).

A2b. Clinical Guidelines

Assessment of asthma is done to determine the severity of the disease process. Once the intrinsic intensity of the condition is identified, therapy can be initiated. Moreover, asthma control is assessed to monitor and make necessary adjustments to the treatment being undertaken. Asthma control encompasses the level to which the manifestations of the condition, including symptoms and functional impairments, are reduced, and the objectives of therapy achieved (BCBSNM, 2018). Also, assessment aids in the scheduling of follow-up care necessary to ensure the condition is efficiently controlled and managed.

Diagnosing asthma generally includes medical history, physical examination symptoms, and general health and examination results. Decisions for asthma treatment are based on two clinical assessments, namely spirometry and airway hyperresponsiveness. Sputum eosinophil marks the airway’s inflammation; therefore, it is a useful tool for measuring severity and response to treatments in asthmatic individuals (Bandyopadhyay et al., 2013).

Patient education and active monitoring are vital for ensuring self-management and optimal results (Bernstein & Mansfield, 2019). This aims at improving patient knowledge, decision, and control. In collaboration with caregivers, asthma patients get an opportunity to discuss the inhaled controller medication use by developing a developed decision aid. Patient education facilitates better understanding and management of the illness, and achievement of optimal health potential through personal efforts and commitment (Dima, de Bruin & Van Ganse, 2016).

A2c. Standard practice of Disease Management

The state of Michigan has been running community asthma partnership and health campaigns for reimbursing asthma self-management education home visits at the Medicaid standard rate for experienced nursing appointments. Consequently, the success of the partnerships saw insurers agree to compensate for asthma home visit programs for self-management education, expanding access to asthma care state. CDC’s National Asthma Control Program (NACP) supports patients in the US to gain control over their condition. This is achieved through the funding of the health departments in US states, facilitating the accessibility to pharmacotherapy and management for every asthmatic person. The programs also ensure the collaboration in the healthcare system by financing state-run programs and government agencies, sponsoring actions for quality asthma care, and advising policymakers on the problem of asthma.

A3. Managed Disease characteristics and resources

Effective management of asthma relies on the adequate tracking of symptoms and routine measurement of how effective an individual’s lungs work. Creating a written asthma action plan with one’s physician is an undertaking that is necessary for efficient management of the disease. Action plans are essential as they assist in keeping track of treatment and tracking symptoms. The action plan can be used to track symptoms hence enabling adjustments in treatment to be made accordingly. Also, physicians may facilitate periodic lung function tests such as peak flow and spirometry to determine the degree of efficiency of the lungs (MC, 2019).

Adjusting the treatment per the action plan also plays a vital role in the management of asthma. The action plan helps in planning whereby medications might be easily changed in case of changes in asthma control and increased manifestation of symptoms on an individual. The medicines that are used in managing asthma in people include long-term control medications like inhaled corticosteroids and quick-relief inhalers or rescue inhalers that contain fast-acting medications like albuterol (MC, 2019).

Through proper management, individuals living with asthma can achieve a life expectancy like that of people without asthma. However, research has shown that various risk factors may result in a shortened lifespan. Smoking, irritants, and poor lifestyle choices are some of the aspects that may influence the life expectancy of individuals living with asthma (Yanez et al., 2014).

A3a. International and National Disparities

In the US health sector, persistent disparities in asthma management are related to race, income, and education. These disparities are also reflected in higher rates of morbidity and mortality amongst minority populations. The discrepancy in asthma care has socioeconomic roots (Holsey, Collins & Zahran, 2013). Coordinated national action plans have become essential in reducing these disparities in asthma, where they are more prevalent in children (Ashley et al., 2017). Internationally, asthma outcomes, including the severity of and control over the condition, are linked to factors past race such as income, education levels, insurance status, and health literacy (Reichel, 2017).

In the United Kingdom, three out of five individuals do not acquire primary asthma care. Moreover, young people are recorded as the recipients of the worst level of primary care since the currently relied upon models of care are not comprehensively meeting their needs (UK, 2018). Eighty-eight percent of 18-29s are living with uncontrolled asthma in the UK. Also, studies indicate that a large number of individuals manage asthma attacks alone. Furthermore, people who have asthma in the UK fail to take their medication on a regular occasion due to the costs involved. Costly prescription charges have to be paid when seeking out for care (Campbell, 2019).

In Brazil and other Latin American countries, there is a high prevalence and great degree in the intrinsic intensity of asthma among patients. Research indicates that individuals are often inadequately controlled and their degree of asthma control overestimated occasionally compared to the standard employed by global asthma treatment guidelines (Solé, Aranda, & Wandalsen, 2017). The individual and social burden of Asthma in Brazil may be reduced through the facilitation of enhanced education for physicians and asthmatics.

A4. Managed Disease factors

Managing this condition requires significant financial resources, access to care and health literacy.

Financial Resources: The global prevalence and incidences of asthma have increasingly grown due to environmental and lifestyle changes. Managing this condition requires significant financial resources that cause a high disease burden. Disease-related costs can be either direct, indirect, or intangible. Asthma management, complementary investigations, or treatments requires significant financial resources. Asthma also can lead to work-related losses and early mortality that also affect patients and immediate members. The ultimate results of lack of financial resources remain the reduced quality of life, increased discomfort or distress, restriction of physical activities, and alterations of work.

Access to Care: The management of asthma significantly relies on the accessibility to care by patients. Access to a health care team is crucial since it assists in the creation of an asthma plan for controlling the disease. In severe cases of asthma, it might be necessary to see specialists who would be better placed to provide expert management than primary care physicians. The access to proper medical attention is reliant on various aspects, including socioeconomic status, insurance status, and availability of specialists in the area from which a patient resides (AAFA, 2020). Furthermore, access to specialists such as pulmonologists, allergists, and immunologists is critical in the acquisition of newly available biological treatment for the management of the disease (Menzies-Gow et al., 2018).

Health Literacy: It is a significant aspect that influences asthma management outcomes. Having sufficient levels of health literacy enables an individual to adopt the best practices in the management of their medical conditions. Health literacy gives a person an idea on the primary health information that is necessary to control the disease. Therefore, health literacy ensures the appropriate levels of knowledge among patients regarding the necessary and proper medical practices that are vital in aiding the efficient management of the disease.

A4a. Unmanaged Disease Factors

In many countries, non-communicable diseases, such as asthma, hardly becomes a healthcare priority. This makes access to care limited and low. The condition is more prevalent in areas where health literacy and education level are very low. Lack of access to care leads to more cases of asthma, reduced quality of health. This means people, especially children, will receive suboptimal medication with poor attention and substandard care.

Healthcare insurance is directly linked to the quality of healthcare. The minority groups are more expected to be uninsured or to have non-private covers. State-sponsored insurance programs provide health coverage to low-income and uninsured patients, but access to health coverage remains a challenge. Uninsured families are less likely to afford their children’s prescription medicine or make an appointment to a physician or expert for therapeutic care than the insured asthmatic patients (Holsey, Collins & Zahran, 2013).

Health literacy informs most of the treatment decisions of patients. Individuals with low health literacy tend to act inappropriately. Due to poor knowledge regarding their conditions and treatments, patients may carry themselves in an undesirable manner such as skipping necessary tests and procedures or wrongfully administering medications which could negatively impact on their management of the disease (Krishnan, Rohman, Welter, & Dozor, 2018).

A4ai. Unmanaged Disease Characteristics

Patients with unmanaged asthma may uncontrollably display the symptoms of coughing, wheezing, shortness of breath, and chest tightness (Fuller, 2018). The occurrence of symptoms more than two times a week is an indication of a person with unmanaged asthma. Coughing at night is also a symptom that is displayed among individuals with uncontrolled asthma. Moreover, requiring to use rescue medication more than twice a week often signifies that the asthma symptoms are unmanaged; hence vital focus should be set on treatment.

Furthermore, patients with unmanaged asthma would record peak flow measurements that are lower by 15% of the recommended levels. Also, patients with unmanaged asthma get out less due to the symptoms impacting on their quality of life. Patients are often stressed and emotionally burdened with their inability to facilitate a social life due to the continuous experiences with the symptoms of asthma (Fuller, 2018).

Patients, Families, & Populations

Burden to patient

Asthma patients bear an enormous burden of the disease. Individuals living with asthma have an unrelenting pressure to manage their condition, which leaves them frustrated some times (Dunne & Hughes, 2015). The frustrations regarding their health and well-being work to negatively influence their work and social relationships. Persistent coughing might make one uncomfortable with sharing spaces with other people hence limiting their social interactions. Moreover, since vigorous physical activities might trigger an asthma attack, patients get discouraged from participating in exercises.

Burden to family

Asthma as a disease also has an immense consequence on the family of the patient. The frustrations of patients might affect their attitudes and moods hence influencing their social roles within the family. Some of the social functions in the family may be abandoned if a parent is suffering from the disease. Family dynamics is also shifted by the condition whenever specific family roles that are typically undertaken by a patient cannot be performed by them anymore.

Burden to community

Asthma is also a massive burden on the community. Patients with asthma flood the health care systems seeking medical care, and some cases might require hospital admission. Hospital admissions result in the reallocation of resources that would have been utilized by other members of society. Furthermore, workdays lost due to the condition impacts the overall productivity of an individual and the community. Also, asthma causes millions of premature deaths annually all over the globe. This presents a challenge to communities by having to bear with the losses of people who would have otherwise been productive in society.

B1. Costs

Asthma is a costly disease that burdens patients, families and communities. The costs incurred from the illness often arise from the medication requirements for treatment.

Cost to the patient:

Although asthma is generally recognized as a costly disease, its total costs to the community are hard to estimate and vary across the world. For instance, asthma cost is estimated to be $USD 1,900 in Europe compared to $USD 3,100 in the US (Nunes, Pereira, & Morais-Almeida, 2017). The overall cost encompasses both the direct cost such as medications and hospitalization and indirect costs, such as lost working days and production. The price of inhaled asthma prescriptions has grown, making inhalers costly.

Cost to the families:

Asthma also imposes a tremendous financial burden on the family. Household income is mainly affected by the costs of asthma due to the need for medical care of patients. The disease further divides up household income that would have been of great use in other areas such as food. Moreover, a family with a medical history of asthma is at risk of being given increased premiums on insurance hence making it more costly to acquire medical cover.

Cost to the community:

Asthma necessitates for various initiatives to create awareness in the community on multiple aspects. Outreach and education programs are necessary to ensure that members of the community know the symptoms of asthma and its triggers. These programs are crucial in ensuring individuals seek out medical attention when they experience the symptoms of the disease. Furthermore, a lot of costs go into the funding of facilities and research that is directed towards deducing methods and drugs that improve the quality of life of patients.

Best Practices Promotion

The best practice for managing asthma would be providing self-management patient education. The complexity of asthma requires the patient to be educated on how to manage their medication. Proactive and continuous learning, usually via multiple sessions, will demonstrate, exercise, and reinforce information and appropriate practices for asthma management. Patients thus gain knowledge in how to reduce asthma symptoms, enhance the quality of life, improve medication adherence, enhance activity limitations or restrictions and, more importantly, reduce medical costs.

Providing self-management improves asthma control and decreases hospitalizations or emergency appointments (Federman et al., 2019). Persons with moderate to severe persistent asthmatic conditions need comprehensive training to strengthen and increase communications that are usually inadequate during health care visits. This entails ensuring the accessibility of evidence-based education programs and properly educated workforce to assist patients in managing their condition independently. Improved asthma control and decreased hospitalizations, and emergency department visits is an excellent evaluation tool for self-management strategies.

C1. Implementation plan

Chart reminders would serve adequately in the implementation of best practices for asthma. An asthma-management flowsheet may be used to track the details and actions of each patient visit and records the severity ratings each time. Diagnostic criteria and a summary of the preferable medications may also be recorded on the chart reminders to ensure that the attending nurses comply with the patient-specific needs.

Patient self-assessment may also be used in the implementation of the best practices in dealing with asthmatic patients. The completion of self-assessment forms serves to assist nurses in taking a more significant proactive function in the control of asthma and also to challenge patients to engage actively in their care. Moreover, self-assessment is essential in nursing since it assists in identifying opportunities for intervention, such as the provision of education.

Facilitating home visits is also an essential strategy for implementing patient education. Encouraging collaborations in the delivery of home visits will ensure sharing resources, transfers, and education among different teams assisting similar populations. This will increase the accessibility of self-management services (Centers for Disease Control and Prevention, 2015). Home visit programs can be evaluated through increased control of asthma at home and reduced hospital visitation or stays.

C2. Evaluation Method

Patient experience of care may be used as a tool to evaluate the effectiveness of chart reminders as an intervention in the nursing field. Chart reminders are purposed to keep track of employee needs and facilitate quality care. Therefore, a patient’s experience would be useful in determining whether care, as guided by the chart, is sufficient. Moreover, peer assessment would be significant in evaluating the success of the chart reminders as an intervention due to the multiple professionals that utilize the initiative.

Moreover, self-reflection would be vital in measuring the success of patient self-assessment. The self-reflection can be done by the patient who gauges and determines whether they gained a better understanding of their health and well-being. Also, self-reflection would be critical in evaluating whether there is an improved patient perception of care.

Establishing linkages across the sectors is a crucial strategy for improving the population’s health and positive returns on investment. Collaboration ensures the efficient provision of essential services without replication or wastage of resources. Investing in information-sharing tools resolves confidentiality and interoperability concerns, streamlining communication across different interrelated sectors. This allows direct referrals by using an electronic health recording system to a suitable community or home-based facilities. The approach can be evaluated by improving health outcomes and decreased expenses (Centers for Disease Control and Prevention, 2015).

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Qwest Communications International Inc. art history essay help

Qwest Communications International Inc.

1- Introduction

Qwest Communications International Inc., a telecommunications company, based in Colorado was founded in 1996 by Philip Anschutz. The nature of services offered includes internet, telephony, and television. As of 2007, the total asset value was $22.5 billion with revenues of $13.7 billion. Joseph Nacchio was appointed as the CEO of the company in 1999 and adopted what was later referred to as “aggressive accounting”. The company was later involved in numerous illegal and unethical accounting measures that involved both the top management, CEO, and some trading partners.

2- Background

The accusation against Qwest for the falsification of financial statements came in the year 2003. The firm was accused of swapping of their pieces of telecommunication equipment with other service providers in the same industry. The firm, therefore, recognized the transfers in their books as revenues. The repeated booking of one-time sale of equipment and fibre optic swaps lead to an inflation of the company revenues to the extent of $2.2 billion between April 1999 and March 2001. The earnings of the company were inflated by $358 million. The “swapping” of equipment was supposed to have a net-zero balance on the books of the company, but they instead ended up recognizing it as revenues.

The nature of the offence is such that there was excessive internal trading by board members and senior executives between 1999 and 2001. The valuation of the company influenced its acquisition by US West in 2000, and the company stock prices were boosted based on falsified accounting processes. The top management of the company also issued “side letters” that varied the terms of trade in the earlier contracts. The information was not availed to the then company CFO when varying such contracts implied the revenues that are to be generated by the company. The company Board made over $1.5 billion by selling company shares, where the founder, who summed up as the promoter of the company sold $2 billion shares within the same period.

The member to the audit committee, Jordan Haines was a long-time family friend to the company founder. He maintained that he had no idea of the accounting issues but shifted the blame to the company auditors, Arthur Andersen. It points clearly to the ineffectiveness with which the internal audit department conducted its processes. The internal audit department is required to check on the soundness of all accounting policies adopted within a firm and advise other departments accordingly.

3- Alternatives

Different alternatives can be adopted to avoid the problem in future. First, there is a need for a strong internal audit team with no close relationship with responsible officers of the company. The internal audit department needs to assess and criticize the accounting policies adopted in the preparation of financial statements. The internal audit department in place is already compromised in their functioning. Independence of the internal audit function ensures that it functions properly and that reporting is done as soon as anomalies in accounting policies are adopted.

Second, the constitution of the company’s Board of directors needs to be changed. The Board has an important role in establishing accountability for the management of the company. It ensures that the departments have independence in their functioning. It was not the case for Qwest as it furnished the potential investors with wrong information on the performance, leading them into making wrong investment decisions.

Thirdly, the role of the audit committee is to provide oversight of financial reporting and other related controls which was not the case for Qwest.

4- Proposed Solution

Qwest needs to have a fully constituted audit committee that will be responsible for overseeing ICFR. Internal Control over Financial Reporting is the responsibility of the management. The audit committee will work with the internal auditors, management, and the independent auditor, and this outlines their essential role within an organization. The committee also has the responsibility of overseeing the entire accounting process. It will be in a position to assess the controls set in place and measure their effectiveness. The audit committee will, therefore, look out for potential risks in the financials that include frauds in financial statements, asset misappropriation, and cases of corruption.

The role of the audit committee also includes analyzing how the management has reported significant financial issues in the financials. The committee also assesses the judgement used by management in preparing financials. The audit committee, through the COSO framework (Committee Sponsoring Organizations of the Treadway Commission), outlines the essential aspects of governance. Organizations need to have open lines of communication between the management and the Board. Separate lines of communication, such as whistleblower hotlines. Processes are to be set in place that guides the review and approval of transactions between related parties and other substantial transactions. It also involves reviewing the related contracts and any other relevant documentation.

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