Assessment 1 Instructions: Community Resources And Best Practices You Will Develop A Writing Help - Best History Assignment Help By Professors

Assessment 1 Instructions: Community Resources and Best Practices

You will develop a presentation consisting of 8-10 slides for the leaders of a health care organization or community-based care delivery service in which you explore current organizational or community resources for a specific situation related to care delivery.

Introduction

Note: Complete the assessments in this course in the order in which they are presented.

To affect quality care coordination as a leader in practice, you have to understand the outcomes you want to achieve, the best practice that supports the outcomes, the related legal and ethical concerns and how to determine recommendations to produce the outcomes. This includes collaboration with the interprofessional team, data use, and the ability to communicate clearly and precisely.

Note: Complete the assessments in this course in the order in which they are presented.

Preparation

This assessment requires you to create a presentation and record a voice-over track or video of you presenting it to an audience. For tips on creating a PowerPoint presentation, refer to the Effective Presentations section in the Resources for this assessment. Refer to the Using Kaltura tutorials to learn how to use Kaltura to record your presentation.

Note: Remember that you can submit all, or a portion of, your work to Smarthinking for feedback, before you submit the final version for this assessment. However, be mindful of the turnaround time of 24–48 hours for receiving feedback, if you plan on using this free service.

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.

The quality of care coordination outcomes may depend upon efficient use of health care information systems.

How do you start to assess the needs of a community related to care coordination when you think about outcomes?

Legal and ethical implications of implementing or changing any care coordination practice can have far-reaching effects.

As you think about improving care in the community with enhanced interprofessional coordination, what types of ethical and legal issues come to mind if care coordination does not improve?

Context

Using health care information systems to effect change is critical to creating quality outcomes. A leader in practice for care coordination needs to be able to measure and evaluate change using data.

Requirements

You will develop a presentation for the leaders of a health care organization or community-based care delivery service in which you explore current organizational or community resources for a specific situation related to care delivery. Your presentation will include either voice-over or video of you speaking about your presentation to the audience. Your slides should include bulleted points (one line each) that highlight your points for each topic. Your slides should not be text-intensive; put all the details in the speaker notes.

PRESENTATION FORMAT AND LENGTH

At a minimum, your presentation must include the following slides:

Title.

Purpose (the reasons for your presentation).

A specific situation related to care delivery and current organizational or community resources.

The legal and ethical issues that can occur due to the current practice.

Recommendations for improvement and a comparison to current practice.

An evidence-based intervention.

Explanation of data use and interprofessional support.

References (at the end of your presentation).

The content of your presentation should consist of 8–10 slides, not including the title, purpose, and references slides. Do not exceed 10 slides as this could create problems for submitting your work to SafeAssign.

Note: You may vary from the suggestion above, but you must meet all the criteria listed below. Please read the full instructions carefully.

SUPPORTING EVIDENCE

In your presentation:

Cite 5–7 sources of credible, scholarly, or professional evidence to support your analysis and recommendations.

List your sources on the references slide.

PRESENTATION TOOLS

You may use Microsoft PowerPoint or any other suitable presentation software to create your slides. If you elect to use an application other than PowerPoint, check with your faculty to avoid potential file compatibility issues.

Use the speaker’s notes section of each slide to develop your talking points and cite your sources, as appropriate. If you need help designing your presentation, you are encouraged to review the various presentation resources provided for this assessment. These resources will help you to design an effective presentation, whether you choose to use PowerPoint or other presentation software.

You have the option of either recording a voice-over track for your presentation or creating a video of you speaking about your presentation to the audience. In the latter, the presentation will be in the background and you will be on camera. In either case, you may use Kaltura or similar software for your audio or video recording. If using Kaltura, refer to the Using Kaltura tutorials for directions on recording and uploading your media in the courseroom.

Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact [email protected] to request accommodations.

Directions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. Be sure that your presentation addresses each point, at a minimum. You may also want to read the Community Resources and Best Practices Scoring Guide to better understand how each criterion will be assessed.

For this assessment, you will create a presentation for the leaders of a health care organization or community-based care delivery service to explore current organizational or community resources for a specific situation related to care delivery. Following these instructions will help ensure you meet the scoring guide criteria:

Begin your presentation with a description or summary of a specific situation related to care delivery and current practices. Analyze the legal and ethical issues that can occur due to the current practice.

Recommend best practices (interventions) and compare against current practice outcomes or data. Include the positive effects of the intervention for the support of ethical and legal practices.

Identify an effective evidence-based intervention from existing research applicable to your situation. Define stakeholders, including organizations, settings, and populations affected. Be inclusive when considering the range of stakeholders.

Define interprofessional support for the intervention. Explain not only if this includes stakeholders, but also who is responsible in collaboration with care coordination leader for developing, implementing, and sustaining the intervention.

Explain how you will measure baseline data. (What data are currently in place? Does current data show if practices are effective? Are benchmarks being met? Is there a gap in practice?) Define the scheduled evaluation periods you will use to monitor and measure data outcomes (for example, systematic evaluations or other).

Conclude by developing recommendations to sustain the intervention outcomes for improved practice.

Scoring Guide Criteria

Your assessment should meet the following scoring guide criteria:

Analyze the ethical issues pertaining to using health care information systems for care coordination.

Evaluate the legal issues of current practices and potential changes.

Compare current outcomes to outcomes seen with best practices.

Identify an appropriate evidence-based intervention.

Define role of stakeholders and interprofessional teams in an intervention.

Explain the use of data-driven outcomes, including data measures and evaluation periods.

Recommend ongoing practices to sustain outcomes.

Communicate effectively in a manner consistent with professional and scholarly expectations.

Additional Requirements

Your assessment should also meet the following requirements:

Communication: Communicate in a manner that is scholarly, professional, respectful, and consistent with expectations for professional practice in education. Original work and critical thinking are required regarding your assessment and scholarly writing. Your writing must be free of errors that detract from the overall message.

Media presentation: Include 8–10 slides, with notes or a transcript to ensure accessibility to everyone. Upload the presentation.

Resources: Include 5–7 scholarly resources, other than the text or articles in the Resources. Include citations at the end of the presentation.

APA guidelines: Resources and citations are formatted according to current APA style and format. When appropriate, use APA-formatted headings.

Font and font size: Use a professional-looking font of appropriate size and weight for presentation, generally 24–28 points for headings and no smaller than 18 points for bullet-point text.

Portfolio Prompt: You may choose to save this learning activity to your ePortfolio.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 1: Analyze the use of ethics to enhance coordinated care.

Analyze the ethical issues pertaining to using health care information systems for care coordination.

Competency 2: Evaluate the legal implications in care coordination.

Evaluate the legal issues of current practices and potential changes.

Competency 3: Critically appraise collaborative and interprofessional relationships with care coordination stakeholders.

Define role of stakeholders and interprofessional teams in an intervention.

Competency 4: Recommend care coordination standards of practice for working with stakeholders.

Compare current outcomes to outcomes seen with best practices.

Identify an appropriate evidence-based intervention.

Recommend ongoing practices to sustain outcomes.

Competency 6: Assess data outcomes for care coordination processes.

Explain the use of data-driven outcomes, including data measures and evaluation periods.

Competency 7: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards.

Communicate effectively with stakeholders, in an appropriate presentation form and style, consistent with professional and scholarly standards.

SCORING GUIDE

Use the scoring guide to understand how your assessment will be evaluated.

VIEW SCORING GUIDE

Types And Properties Of Skin Grafts Case Study Argumentative Essay Help Online

The paper Types and Properties of Skin Grafts That Are Transplanted to Damaged Areas of the Body” is an informative example of a term paper on health sciences & medicine. When we get burned enough to destroy our skin tissues, we would need to undergo skin grafting. Grafting is a surgical procedure wherein tissue is moved from one body part to another, or from one person to another, without bringing its own blood supply with it. The blood supply is dependent on the site where the skin is transferred.
The most common grafting procedure is skin grafting. This most often happens in burns, as in the case mentioned above, although there are other situations wherein there is a need for skin grafting. Whenever there is damaged skin, skin grafting is needed. The transplanted skin tissue is called a skin graft. It consists of the epidermis and dermis, though the blood supply is not included with it. There are two types of skin grafts: split-thickness and full-thickness (Triana, p.41). consist of the epidermis and a segment of the papillary dermis.
The thickness depends on where it came from, the body part and the skin color. These are usually harvested with a razor blade. The thinnest parts are the eyelids and the thickest are the soles of the feet (Triana, p.41). Split thickness grafts are highly reliable but have limited usefulness, such as repairing wounds in the scalp (as in brain surgeries). Full-thickness grafts, on the other hand, are most useful for facial defects, although they have higher graft failure. These are thicker as the entire thickness of epidermis and dermis is harvested.
There should be adequate blood supply in the recipient site to make sure that the skin graft will survive. This is usually done with or severe infections. Split thickness skin grafts are more successful than full-thickness because of the it has although it may be less durable (Swalm, p.327). Hair growth may also be absent with split-thickness grafts. A skin graft is not merely used for beautification purposes. It is primarily used to close a wound.
It serves as a wound covering, important in the healing of that particular wound. It also serves as a replacement for missing skin, a covering that is necessary for protection. If damaged skin remains open or unhealed, it will cause further damage not just in the skin area but underneath it as well. It can also compromise the health of the patient as it may become infected. Skin grafts are recommended for the following reasons: surgeries, like in head injuries, ulcer, skin cancer surgery, burns, very large wounds, and cosmetic or reconstructive surgeries.
The procedure for skin grafting is very delicate. Any failure in the proper procedure may mean bleeding, infection, damage of the skin graft or nerves of the patient or rejection of the skin graft by the recipient. It is very important that the recipient site is clean and free from any dead tissue, foreign matter or bacterial contamination as these may jeopardize the entire operation. Other risks for the surgery are bleeding reduced or increased skin sensitivity, scarring, skin discoloration or uneven skin surface.
Skin grafts are not simple operations wherein you patch a wound with skin tissue. It is a delicate procedure. It is not merely used to enhance ones beauty as what is commonly known for facial surgery. It is an important surgery to ensure that ones large wounds are closed and healed to prevent further damage in the tissues and blood vessels of the patient.

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Last resort, if the above does not work, we will refund your money.

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Fatigue and Physical Activity in Older Women write essay helpIn the article of Crane (2005), kinds of literature support fatigue and depression as side effects of in older women after myocardial infarction (p. 35). Following the literature review of the article, a nurse might decrease the dosage (under dosage) or not give the at all due to the supporting kinds of literature of the article that beta-blocker medication can cause fatigue and depression; thereby, reducing the incidences that older women must engage in physical activity. With these, older women after myocardial infarction might be at risk to develop and aggravating of symptoms as patients with myocardial infarction should receive the appropriate dose of , throughout hospitalization, after discharge, and for long-term therapy to decrease the incidence of such as heart failure (Day, Paul & Williams, 2009, 821).A number of studies found a correlation between age and unpleasant symptoms of fatigue to the participation of older women in exercise regimens after myocardial infarction; however, the study of Crane (2005) found no association between fatigue and physical activity (p. 37). If nurses would apply the findings in practice, they would either decrease or increase physical regardless of the effect of the degree of exercise on the health status of the individual. In this case, patients with decreased physical activity may be more exposed to cardiac risk factors as an active lifestyle decreases cardiac risk factors. On the other hand, patients with increased physical activity might be at risk to suffer from fatigue, leading to aggravating symptoms of myocardial infarction, or worst, heart failure.To prevent the risks of under dosage and increasing risk of cardiac risk factors, further studies focusing on the dose of beta-blockers and an in-depth analysis of the correlation between physical activity and cardiac risk factors in a larger sample must be conducted. This is to establish a standard dose of beta-blocker medication for older women after myocardial infarction and to rule out the relationship between physical activity and cardiac risk factors

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Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.
Finance
Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.
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Computer science is a tough subject. Fortunately, our computer science experts are up to the match. No need to stress and have sleepless nights. Our academic writers will tackle all your computer science assignments and deliver them on time. Let us handle all your python, java, ruby, JavaScript, php , C+ assignments!
Psychology
While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.
Engineering
Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.
Nursing
In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.
Sociology
Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.
Business
We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!
Statistics
We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.
Law
Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.
What discipline/subjects do you deal in?
We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.
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What if I don’t like the paper?
There is a very low likelihood that you won’t like the paper.
Reasons being:

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Challenges in Future Direction of Health Care essay help cheap: essay help cheapNumerous challenges are realized in the healthcare sector in a bid to reform and promote health among the populations. A number of these challenges are highlighted below in detail prior to organizational direction and strategies adopted.Information technology advancements including the electronic medical, or health, record (EMR/EHR)Technological advancements have been realized alongside globalization and the modernization of societies. In that regard, technologies for medical and health purposes have come up to aid healthcare service delivery. However, the sectors performance in the context of medical and health technologies has not been as it was initially expected (Afo, Thomason & Karel, 2006). It is true that technology has impacted positively on healthcare and related services, but it has .Medical and healthcare technologies require professionalism, skills and knowledge in use. Where these factors are lacking, there are difficulties in the actual practice application. Another source of the emergent challenge comes from . Direct interaction of patients and healthcare providers is reduced and the overall welfare of patients may be hard to monitor. Issues of privacy and confidentiality have also been cited as substantial challenges due to the fact that users of such technologies do not fully trust technologies.Economics, , future funding, rising costs, the Medicare and Medicaid programsHealthcare systems and programs have to a greater extent revolutionized the healthcare sector and related fields. Massive resources have been pooled and efforts to efficiently allocate resources made. Numerous modes of financing healthcare have been adopted in a bid to fairly and equitably provide healthcare services to the entire population (Ebrahim & Anken, 2008). However, even with these efforts, there are numerous challenges posed by the very same efforts undertaken. One of the most substantial sources of the challenges in this context is the economic factor. Economic hardships and crises have negatively affected healthcare services delivery.Insurance incorporation has been introduced in healthcare financing by providing healthcare covers. However, not everybody can afford the premiums charged by insurance companies. Healthcare costs are on the rise, necessitating the need to address future healthcare funding if this scenario is to be reversed. Other programs like Medicare and Medicaid have not fully met their objectives. For an organization to address these challenges through direction and adoption of effective strategies, then all the influencing factors in the industry must be accounted for.Access to health care including the uninsured and those in the poverty levelsAccess to healthcare is a significant challenge in pursuit of the future direction of healthcare (Ebrahim & Anken, 2008). Even today, a significant proportion of the population remains locked out of . There are a number of reasons behind this observation but the most common is the fact that most are poor to the extent that they prioritize other aspects of life over their health. Any healthcare facility should seek to promote the basic context of healthcare affordability if its future endeavors in direction of healthcare are to be realized.Maintaining a skilled workforceHealthcare professionals require intensive and critical training procedures before they are allowed to serve masses that . Both curative and preventive measures constitute healthcare services (Afo, Thomason & Karel, 2006). Professionals in this field have a fundamental duty and responsibility to play, both for the individuals and the society at large. As much as they promote the populations health, their social welfare has to be factored in. Maintaining a skilled workforce is an expensive undertaking. In this regard, highly qualified personnel in the health industry have at times quit their jobs in search of greener pastures. This jeopardizes the future of health care and related activities in society. Therefore, direction and strategy adoption by a healthcare organization must clearly outline a workable plan of keeping a skilled workforce in the industry for the longest time possible.Pay for PerformanceHigh organizational performance is the goal of any given health facility. Creating incentives that trigger high organizational performance is bound to work out to the advantage of every stakeholder in the health sector. However, this principle is lacking in many healthcare facilities. Even the most effective and efficient organizations go unnoticed. Lack of reward schemes in hospitals or other healthcare facilities does not motivate these organizations to perform.DOWNLOAD FULL PAPERShare:

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Teenagers to Avoid Possible Future Complications college essay help serviceThe paper Morning-After Pill Should Not Be Available to Teenagers to Avoid Possible Future Complications” is a telling example of a term paper on health sciences & medicine According to reports by the General Household Survey of the government, 1 in every 8 teenage girls aged 16 has taken the morning-after pill at least once. This is a very alarming number if one would consider the number of other underage kids who uses this contraceptive all across the nation. It further states that 12% of teenage girls aged 16-17 have used this pill after engaging in sexual intercourse.
Furthermore, .5% of these teenagers have used this pill at least twice, and .25% of these teenagers have used it even more often. According to the reports, the pill is so easy to acquire, that 50% of those who used it got it from their doctors or nurses, and around 25% bought it over the counter, while the rest of the users got it from family planning clinics (Kelleher, 2010, p.302-4). While it may be true that the morning after pill can help a lot in special cases, the easy availability of such especially to underage kids — and with such large numbers patronizing it — raises serious health concerns.
According to President Obama: – I think it is important for us to make sure that we apply some common sense to various rules when it comes to . And as I understand it, the reason Kathleen [Seblius] made this decision was she could not be confident that a 10- year-old or an 11-year-old.should be able, alongside bubble gum or batteries, be able to buy a medication that potentially, if not used properly, could end up having an adverse effect. And I think most parents would probably feel the same way. (Belz) This alone speaks a lot of the concerns from adults when it comes to allowing underage kids to have access to these pills.
While statistics have not stated it yet, such options for not getting pregnant could encourage more and more underage kids to engage in sexual intercourse (Kelleher, 2010, p.291). This can easily lead to thinking how much more problems regarding STDs will this issue raise. The reported numbers of teenagers using this contraceptive pill show that the original safe sex message of using condoms for prevention not only of unwanted pregnancies but also of STDs (Godfrey et al., 2010, p.
545 and Kelleher, 2010, p.293). While the morning-after pill can really be useful in emergency cases of preventing unwanted pregnancies, it surely does not prevent unwanted transmission of STDs. The morning-after pill also encourages irresponsible intercourse from the younger generation. This does do not speak well in terms of the physical, emotional, and mental health of these young people since it breeds the feeling of doing something just because they can get away with it. It also increases the careless action of disregarding other serious outcomes, like STDs and responsible sex (Godfrey et al., 2010, p.545-6), and just focusing on not getting pregnant.
Despite the argument that everybody is equal in terms of human rights, there are just some things that should be taken into consideration with the age of the doer. Physically, mentally, and emotionally, adults are different from minors (Kelleher, 2010, p.295). In terms of physical health, there are studies that confirm how the use of contraceptive pills by young girls can raise the risks of developing breast cancer during their adult years. The younger the girl’s age when she starts using pills, the higher her risks of developing breast cancer (Hensley et al., 2010, p.279).
Because of this, minors should be protected from doing harm to their bodies that could adversely affect their health during their adult years. Furthermore, it is not indicated that the morning-after pill can be used routinely (Hensley et al., 2010, p.279) to prevent unwanted pregnancy. This fact brings about the concerns on the mental readiness of these minors. Just as Pres. Obama stated it is quite bothering to allow girls as young as 10 or 11 to b able to easily purchase morning-after pills as if buying candies (Belz).
Despite the argument that many teens are more mature than their age, their mental knowledge and discipline in using drugs such as these may not b at its peak yet. There are chances that they really do not understand the weight of their effects on their bodies come adult age. The nation’s problem on the use of illegal drugs among adults is enormous, so how much more can a nation fully entrust to kids a decision to that might cause side-effects that they might not know about (Hensley et al., 2010, p.281).
The point here is, if adults can abuse what is illegal, how much discipline can one expect from a minor in using something that is legal? Furthermore, there are also concerns when it comes to the emotions of these minors. Everybody knows how hormones affect teenagers during puberty. Giving them access to such options that almost carries with it no responsibility does not help in forming their attitude towards things (Kelleher, 2010, p.294). It is enough that they have access to things that can prevent STDs, but at least it teaches them safe sex.
The morning-after pill does not teach these kids anything other than doing things irresponsibly. Minors should not be allowed to have easy access to morning-after pills. It only solves one issue (and not even 100% of the issue) of unwanted pregnancy, but it adds to a whole gamut of issues from the sense of responsibility to the transmission of STDs, to the possibilities of negative side effects. While many people might say that the feeling of being bothered at having these is a conservative viewpoint, it is a conservative viewpoint with a solid basis.
In fact, these young kids may even still be getting their money from their parents (Kelleher, 2010, p.297), and the simplest question to ask is: Do you parents even know or agree to you buying and taking morning-after pills?

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Interaction Between Patients and Providers my assignment essay help london: my assignment essay help londonThe paper The Use of Cell Phones Improves Patient Self-Care, Interaction Between Patients and Providers” is a great example of a literature review on health sciences & medicine. The first source is an article on in the Journal of Diabetes Science and Technology. The study evaluated the impact of cell phone interventions for persons with diabetes and/or obesity in improving health care outcomes, and the processes of care for persons with diabetes and/or obesity.
The study was extremely personalized in the sense that it took into account individual patient history, age, , among several other factors. Personalized tips on diet and nutrition were also provided to the patients. Overcoming obstacles and maintaining regular exercise regimes were also addressed. The findings revealed that the use of cell phones improved the interaction between patients and providers, and also between parent and child. It also resulted in greater satisfaction.
It was also noted that outcomes are improved through automated reminders and timely treatment. (Holtz & Lauckner (2012) asserts that knowledge of self-care and self-management was also greatly enhanced using cell phones. However, there were problems with the validity of the information provided by patients. The second source is an article published in Diabetic Medicine Journal, in the year 2010. Its objective was to study the effect of mobile phone usage on glycaemic control in diabetes management.
It cites high cell phone penetration as an opportunity to exploit this quest. (Krishna & Austin, 2008) notes there is greater interaction between patients and providers as a result. Cell phones were used to deliver test results, SMS reminders of visits were also sent. All these interventions aimed at reinforcing lifestyle management. Self-monitoring of glucose, for example, could be conducted by the patient. Overall, a huge drop in HbA was detected (Krishna & Austin, 2008). However, it was greater in the second type of diabetes.
Significantly, it was noted that the results of mobile phone intervention did not vary a lot across demographics of age, size, among others. These changes in HbA were attributed to patient motivation. Generally, telecare came out not to be suitable for all cases of diabetes because of technical problems such as or internet inaccessibility interference. The last source was the article titled, Diabetes Management via Mobile Phones. Its objective was to identify the most common uses of mobile phones in monitoring and managing diabetes, their potential role in a clinical setting, and the current state of research in the field.
Cheap mobile phones, cheaper costs of communication and accessible mobile applications were considered great aids. The majority of the studies encompassed by this study, however, involved providing cell phones to the patients. The study faults the measurement of interaction, based on the number of text messages exchanged between the provider and the patient. This is because only a small group of highly motivated patients sent the majority of the messages (Liang et al, 2010). As a consequence, the study suggests a closer look at ways of motivating other patients.
The limitation of this study is that it is generalized. The cost of these interventions is also questioned by this study. The study suggests that it should be analyzed to prove its practicality. Lastly, the study points out that most studies give an extremely positive opinion of the patient towards such intervention, but tell nothing about the opinion of the provider (Liang et al, 2010). Generally, technology is welcome in healthcare. However, some issues have to be studied in greater depth to maximize their effects and importance in healthcare.
They include; cost, impact, and practicality on integrating the diabetes management and .

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Sociology
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Impact of Health Insurance Portability Essay a level english language essay help: a level english language essay helpthe physician has to collect enough data to convince the importance of the therapeutic drug he wants to try out with patients in the hospital.The HIM director keeps all the medical records of patients currently in hospital and those who had been there previously including all their medical problems which are necessary for the trial exercise. The director can therefore be able to present the records of those patients after seeking consent from the necessary authorities and how each of these patients involved in the trial is so far reacting or fairing with the test trial of the drug. This is crucial background information for the physician.The other way to help is for the HIM director to inform the physician about the progress of the trial so far since its initiation in that facility. This is simple information to provide since the HIM director gets that information regularly to file and keep it for future use. The director can also get information across to the physician about the limitations and the strengths the research on drug trials has so far had including any number of deaths or reactions to the patients and how that is being contained or has been contained so far. Information about precautionary measures against any leaks of patients confidentiality including their names can be given to the physician (Green and Bowie, 2010).2. What impact do HIPAA and privacy have on this process of health research? What health and personal information about your patients’ are you allowed to release to the physician for the purpose of Research?The and Accountability Act are meant to protect the health information about patients. It does this through a set of standards and rules that health workers are obliged to follow in order to accomplish this goal. With this act of protection of patients health information and assurance of privacy, the HIM director has, therefore, no authority to release some details and information about the patients participating in the drug trial research as it will be a breach of HIPPAs rules and standards. The patients details are therefore protected by all means possible.According to HIPPAs rules and guidelines information given by the doctors about the patient cannot be given to anyone unless, with the consent of the patient, the conversations, insurance information or even the billing information is not allowed to be given to anyone other than the relevant people who have the consent of the patient (Noonan, 2002). This, therefore, means that the physician should have consent from the patients under research in order to obtain any information about them in spite of him being in the research team. With consent, however, the physician can get the basic information about the patients.
3. Do you feel that as HIM director that you and your department should typically be involved in ?I do not think the department and I should be involved in the planning because the work in the Health Information Management office is enough to keep us busy in the department without being that is not necessary. The department handles a lot of information and therefore planning clinical trials may require additional time and resources and this may lead to overworking the staff in this department.Overworking will lead to burnout, lack of concentration and mistakes are bound to happen which may compromise either the clinical trials or the work of handling information within the department. Mix up of information is likely to take place and maybe even release of patients health information to the unauthorized personnel without even consent. Furthermore, planning clinical trials requires higher expertise of qualified researchers and medical doctors which is way higher than the qualifications of an HIM director or of people in that department (Skurka, 2012).4. How should you prepare for the initial meeting with the physician? What could you bring to the table to discuss?There are several things to prepare for that will be presented to the physician. These include the HIPPA rules and guidelines which may be necessary in case the physician wants information about the patient without consent. The other important document is the visitors book which is important for every person who requires assistance from the department to sign for and indicate which information they require. This is necessary for tracking purposes in case doctors or nurses take a patients files and fail to return them.The other item necessary is all the files about the research with about the research. These files should exclude those that are deemed confidential due to ethical standards. Any other information about the research or similar previous research that the HIM director may have in the department and which may seem necessary should be carried in case the physician needs to match their research progress so far with previous almost similar research (McWay, 2009).

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Psychology
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Engineering
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Nursing
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Sociology
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Business
We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!
Statistics
We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.
Law
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Our essay writers are graduates with bachelor’s, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
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Pathway of Failed Metal On Metal Hip Implants high school essay helpThe paper The Causes and Pathway of in Patients” is an exciting example of a term paper on health sciences & medicine. Metal on metal hip implants is built from a that is placed on the hips of people in most parts of the world. However, this procedure has been found dangerous to its patients in the recent past. In essences, the surgeons concerned with this kind of implants surgery have come out to reveal that, although these implants have been a great relieve for most of their patients, they have eventually become risky because they have significant wear out through metal wear debris (Catelas and Wimmer 2011).
Scientists have now revealed that the inflammation in tissues surrounding failing chromium cobalt metal on – metal (MOM) implants is caused by the release of cobalt from the metal debris that wears away from replacement joints (Hallab 2001, p. 736). This is argued to be as a result of corrosion when in contact with body fluids. Additionally, it also argued that corrosion can occur as a result of friction between one metal hip parts rubbing against another (Scott, et al 2011).
This kind of corrosion that emanates as a result of body fluids or friction causes metal debris to enter the circulation system of the body, leading to elevation metal blood levels. Ions are genotoxic and are said to lead to further medical complications. Most patients in the, especially in the United Kingdom and other parts of the world, have had . However, most of these people were recalled since their surgeries had complications of adverse rubbing between the components, to cause nanoscopic metal debris to be released hence causing chronic inflammation and mobility loss in most of the patients (Ostlere, et al 2011).
Failure of metal on metal implant could also be caused by dubious surgery on the patients. Use of large diaphragms (metal cup and metal ball), which slide against each other especially when patients are walking or running, leads to tiny metal elements to wear off and enter into the space around the implant (Hart, 2009). With technical structures that do not match the patients hip structure metal implants that are found on the metal on metal implants which, result from the metal implants been coupled with to painful movement of joints and high levels of metals ions in the tissues and blood accompanied by high rates of joint failure (Whiteside, Lange, Capello and Fraser 1983).
This happens when the patient is going through a surgery or when a patient tries to move around (Dowson, Hardaker, Flett and Isaac, 2004). This further leads to the instant killing of the tissue and spurring of the inflammatory process (Scheerlinck, Deport and Kiewit 2010). In several occasions, patients who have been implanted with large metal -on metal implants have discovered pseudotumors growing in the tissues that surround the metal hip (Rooker and Wilkinson 1980, pp. 506). Examples of that have been recalled and removed from the market of the implant include the Deputy ASP hip implant which was caused by premature failure resulting to numerous revised surgeries (Taher and Power 2003).
It is also argued that when metal debris circulates through the blood, they mix with proteins to cause an immune system reaction due to the debris being foreign resulting to an allergic reaction (Corten, et al 2011. In addition, the immune system causes an extra complication which leads to rejection of replacement and osteolysis, a process of bone dissolving. Naturally, the white blood cells begin to attack the metal as a foreign invader; as a result, bone dissolves and makes the artificial joints weak (Langton, et al 2008).
On the other hand, hip replacement utilizes a larger diameter femoral heads leading to the increased range of motion and improvement and the stability of the joints one of the common complication that is associated with total hip replacement (Dunstan, et al 2008). Moreover, the surgical factor such as the cup and head positions and laxity of surrounding tissues and muscles contribute to the wearing out of metal (Donald, 1990). It has also been found out that the strain distribution on the acetabular aspect is widely affected by the fact that metal components are stiff.
Conclusion It has been found out that metal-on-metal implants significantly wear out through metal wear debris. The inflammation in tissues surrounding failing chromium cobalt metal on – metal (MOM) implants is caused by the release of cobalt from the metal debris that wears away from replacement joints. Corrosion can occur as a result of friction between one metal hip parts rubbing against another.

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The Link between Hospital Clothing and Privacy best college essay help: best college essay helpThe paper “The Link between Hospital Clothing and Privacy and Hygiene, Economy and Smart Materials” is a great example of a research paper on health sciences and medicine.Aims and Objectives To establish the factors that impact the choice of hospital dressing or clothing 2. To establish the importance of clothing in respect of hospital hygiene 3. To establish the importance of clothing in respect of privacy in hospital 4. To establish the effect of fashion in the design of hospital clothing Relevance to Professional or Academic Field There are several ways in which a patients privacy and dignity can be promoted to ensure their modesty.
Privacy refers to the capacity of the clothing to ensure freedom from intrusion while dignity refers to the ability of the clothing to be worthy of respect. Further, modesty refers to the situation whereby the person using the clothing does not feel embarrassed. In order to protect patients from , the clothing used by the hospital should include curtains, screens, walls, clothes, and covers. In addition, patients who cannot wear their own clothes should be given appropriate garments that protect their modesty.
Patients should also be given an opportunity to have access to their own clothes (Iggulden, Macdonal and Staniland, 2009). Beyond doubt, very little study has been done with respect to the clothing and materials used by patients in the hospital. This study seeks to fill the by establishing the importance and effects of clothing, materials, and fashion on patient hygiene and privacy. Literature Review There is a strong culture in hospitals for all patients to identify themselves by putting on pajamas, nightdresses or hospital gowns.
The reason why this is done is not clear, except for those who are acutely ill or those undergoing investigations or active treatment. In many phases of hospital care, it is important to let patients wear their own clothes, but the question is, how these clothes should be designed (Plunkett, 2008). Women hospital clothing should be designed to match with the current fashion. Fashion has received little attention as a gendered phenomenon that only reflects but also influenced how modernity and femininity are conceived and experienced.
Fashion is important in that it shows how the modern female is understood to be modern. In addition, fashion expands human understanding of the relationship between femininity and modernity. A womans clothing should be decent, orderly, and in a good taste. Modesty should be the measure of how women clothes should be designed. Women clothing that doesn’t ensure modesty only bring shame, the women are normally ashamed to go beyond the bounds of what is decent and proper (Iggulden, Macdonal and Staniland, 2009).
Personal hygiene need must be met by the clothing designed for women and teenage counterparts. The clothing ensures that the body is kept clean and remains healthy. Proper clothing also ensures that women have a good positive body image. Neglect of personal hygiene when designing clothes for women and female teenagers may lead to discomfort as well as lead to infection and other serious complications. Constant check up on the suitability of hospital clothing is important for implementing appropriate and .
The nurse is in charged with the responsibility of ensuring that the clothes designed for women and teenagers in the hospital meet their hygiene needs (Manlow, 2009). Dependant clients require the nurses assistance in getting appropriate clothing to ensure their dignity, comfort, and safety which should be promoted throughout all hygiene care procedures. The nurse also has the responsibility of advising the clients on the appropriate clothing to wear while they are recovering from illnesses at home.
All aspects of hygiene, including clothing, are important in the faster recovery of patients (Plunkett, 2008). There are several groups and individuals who believe that womens fashionable dress are immoral and that they lead to poor health of the woman. They hold the view that these clothes should be changed. Their arguments against fashion are strong against the practice of tight-lacing. In particular, women clothing is seen to deplete their physical energies and deprive them of good health.
Smart materials should be used in designing female teenage clothing. Teenage girls have high appeals for fashion; the design should appeal to their desires. Designers have over the years used materials which are fashionable and are of high appeal to the teenage girls (Plunkett, 2008). In economical perspective, the use of material to design women clothing should not result in wastage. For example, long skirts are capable of sweeping up filthy debris from the streets. In addition, the weight of the skirts and petticoats can lead to slow and impaired movement of women and teenage girls.
Further, there are cases whereby clothing designs that use heavy materials have led to uneven temperatures which lead to sickness. Consequently, the faulty suspension of garments should be avoided in the design process. The faulty suspension has been attributed to undue stress on the anatomy females (Plunkett, 2008). According to Cruz (2007), teenagers especially girls have been found to be aesthetically oriented, as well as politically and socially motivated in terms of clothes. In the process of designing female teenage clothes, the designer must consider the occasion to be attended by the girls.
In addition, the material to be used for a particular dress design should also be well thought of. Another important factor in the design of clothes is the age of the wearer. The color should match the age of the wearer as well as their complexion (Cunningham, 2003). Methodology During the study, various sources of secondary data will be relied on including books, journal articles, and website articles. The study will also involve experimentation for the collection of primary data. The experiment will involve a sample of 10 in patients in a hospital.
The patients will be given clothes designed in various ways and made of various materials. The patients will be asked to wear the clothes and their attitudes toward them in respect to their privacy and hygiene noted. The study is expected to take a period of six months. The data obtained from the study will be analyzed using SPSS software to establish correlations between the various variables. Expected Outcome The study is expected to reveal some of the factors that impact dressing in the hospital setup.
The study is also expected to reveal which factors mostly affect the preference for certain materials and designs. The results of the study hopefully will be beneficial to those designing clothes to be used in hospitals taking into consideration hygiene and privacy factors.

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Diagnosing and Treatment of Adolescent Obesity personal essay helpThe paper “Diagnosing and Treatment of Adolescent Obesity” is an excellent example of a research proposal on health sciences and medicine.This study specifically implements a mixed-methods approach. The rationale for the implementation of the mixed methods approach is that an expansive survey of medical perspectives on base-line issues is necessary; for instance, means of diagnosing obesity. This is best accomplished with quantitative methods. Additionally, however, it is necessary to establish more probing insights into the approach medical professionals take to obesity through the .
Following Walker et al. (2007), these interviews will involve six nurses and six . The analysis of these interviews is accomplished through qualitative methods. Research Questions From an overarching perspective, this research investigates potential ways that medical professionals can increasingly adopt to a greater role in diagnosing and treating adolescent obesity. Within this context of an investigation, the research considers the ways that medical professionals determine obesity.
The research considers medical professionals overriding perspective on the causes of obesity. In another realm of investigation, the research examines perspectives on the extent that medical professionals believe they are responsible for informing patients about obesity problems. Further investigation questions if medical professionals believe that they have the resources and training to aid adolescents with obesity. Hypothesis It is hypothesized that there will be considerable diversity in terms of opinion and perspective among medical professionals.
Approaches to treating obesity, not only in adolescents but also among all members of the population, remain an area of some ambiguity. Even while there may be some accepted approaches to obesity treatment among the medical professionals, it is further hypothesized that these individuals will demonstrate a diversity of perspectives on their particular responsibility to inform and offer patients treatment options. Sampling Techniques As noted, the two sampling techniques are questionnaires and the .
Data-collection procedures The quantitative portion of the research will be collated from structured survey questions with doctors and nurses working within a cross-section of the states medical institutions. The qualitative portion of the research involves semi-structured interviews with six nurses and six primary care physicians. Ethical Concerns Ethical responsibility must form a cornerstone element of any research project. Within the spectrum of this specific research study, there are a number of ethical concerns.
One of the most prominent ethical concerns is the participants privacy. In these regards, privacy concerns will be ensured through administering the questionnaires and interviews anonymously. The participants who respond will only be referred to through a participant number. Diversity Issues There is a clear challenge regarding diversity, as differing populations can potentially demonstrate differing perspectives on obesity. As a means of remaining cognizant of diversity concerns, these research models will implement cultural sensitivity through administering the survey and interviews to a diverse population base.
Resources Needed The main resources needed are access to diverse populations of medical professionals willing to complete the questionnaire. Additionally, it will be necessary to gain access to a group of medical professionals 6 nurses and 6 primary care physicians willing to engage in the .

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Performance Improvement on Information Systems essay help tipsThe paper “Quality Health Care: Strategic Planning-Performance Improvement-Information Systems” is an excellent example of a research proposal on health sciences and medicine. Delivering quality health care is an imperative cause in the modern world with its ever-increasing standards of living, improving citizen awareness and merging concepts of patient rights. Information systems being the key to bring about quality improvement and the revolutionary changes being demanded by them from management realm, involving areas like strategic planning and performance management, basically it is a matter of identifying the relations among these key elements and keeping them well-balanced.
The thesis Strategic planning and performance management is fundamental inputting information systems in place in a health care scenario. Once the information systems are operational, they take over the task of strategic planning and performance management so that the triad falls into place in a forward and , where the bases are strategic planning and performance management. Regular updating of information systems demands support for the peak of the triangle from its bases.
Methodology Research method This study will combine quantitative and qualitative research methods. Data sources 1. A qualitative review of five major studies published between the 2005-2010 period selected on a case study selection basis. 2. Email-interview-based data collection using a questionnaire (with 20 questions), the respondents being a sample of 10 top-level managers, each selected by different major health care institutions in the country to represent them from among their managers.
There will only be one respondent from one institution. Data analysis Qualitative data analysis using case study method will be utilized for analyzing qualitative data collected. will be employed for analyzing quantitative data collected through questionnaire. Scope of the paper This study will help convince health care managers about the need of establishing and constantly upgrading information systems to improve the quality of health care delivery and remind how they are to be an outcome of and all the same an assistance to proper strategic planning and performance management.
Conclusion This study will not only stress the need for in health care to enhance quality but also will illustrate how strategic planning and performance improvement is a precondition and also necessary outcome of this process. Thus this paper will establish the triangular quality improvement model in health care with information systems at the peak of the triangle and strategic planning and performance improvement as its bases. There will be an upward and downward flow of processes from the peak to the bases and also horizontal flow between the bases, as far as interrelationships are concerned.
Annotated Bibliography Wager, K.A., Lee, F.W. and Glaser, J.P. (2009) Health care information systems: A practical approach for health care management. London: John Wiley & Sons. Provides a comprehensive study on the importance of information systems in the delivery of quality health care in modern times and illustrates how an effective strategic plan for the establishment of information systems and its proper implementation leads to performance improvement. Includes plenty of examples that illustrate the point and addresses the urgent need of delivering quality health care.
Discusses each of the three elements, namely, strategic planning, performance improvement and information systems, specifically and also stresses the interrelationship among the three. Lighter, D.E. (2010) Advanced performance improvement in health care: Principles and methods: Principles and methods, Burlington, MA: Jones & Bartlett Learning. Elaborates on how an efficient strategic plan leads to performance improvement and how information systems could be used as the most effective tool towards this end.
Discusses each of the three factors in detail and tells the relationship between strategic plan and performance management which eventually leads to performance management. Reminds that information and knowledge management has to be embedded into the strategic plan as well as the performance management process. A reverse process is also elaborated upon by which an effective analysis of the strategic plan can be carried out using the information system that has emerged out of the plan itself. Lorenzi, N.M. (2005).
Transforming health care through information volume 772. Berlin: Springer. Focuses on the use and scope of information systems in delivering quality health care. Relates the relevance of information support in any the health care sector. Tells how the conventional strategic planning designs fall short of addressing the information systems demands in the field of health care. Addresses the emerging conflicts surrounding this issue and stresses the urgent need of integration of existing theoretical and application-level approaches and methodologies.
Hastings, G.R. (2008). Our journey to performance excellence, Milwaukee, WI: ASQ Quality Press. Depicts the successful history of Saint Lukes Health System and narrates how information systems played a key role in its success. Addresses the individual challenge that a health institution faces in adopting the modern information system and elaborates upon the decision making and strategic planning that went into the process. Tells how the incorporation of information systems improved performance and also the quality of health care being delivered in this specific institution.
Provides useful information on the practical applications of the strategic planning-performance improvement-information systems trilogy. Chaudhry, B., Wang, J., Wu, S., Maglione, M., Mojica, W., Roth, E., Morton, S.C. and Shekelle, P.G. (2006) Systematic review: Impact of health information technology on quality, efficiency and costs of medical care, Annals of Internal Medicine, 144, 742-752. Provides information on how information systems help improve quality, efficiency and reduce costs in health care delivery.
Gives an extensive analytical review of almost all the major previous and recent works on the topic. Focuses on four major health care institutions and thus provides data that is contemporary and based on practical experiences.

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Effective Food Safety Approaches Case Study college admission essay help: college admission essay helpThe quality of the food would include the overall safety of the food that will be consumed by the customers.
Providing the Hazard Analysis Critical Control Point (HACCP) process to the employees on a regular basis will be very helpful in promoting food safety (Altekruse, 1997). Through this process, certain steps in food preparation can be identified where contamination may occur; and preventive actions can be proposed prior to their occurrence. Furthermore, regular training gives the employees a sense of alertness during their work in the kitchen.
As the head of the , I believe it is an obligation of the restaurant employees, and the entire food industry as well, to provide the best quality that can be served to the consumers. The on the other hand has the responsibility to oversee and monitor that such training is regularly provided to the employees.
1b. Describe worker behaviors that may promote or compromise food safety. Please be sure to justify your opinion with literature.
Proper food preparation such as thorough heating of food and making sure that eggs and hamburgers are cooked well promotes food safety. Workers must also make sure that no cross-contamination occurs from the raw ingredients to the cooked food that will be served to the consumers. Personal hygiene must be second nature to these employees to ensure cleanliness. Practices such as washing hands, wearing proper clothes inside the kitchen and cleaning the workplace will minimize the occurrence of food-borne illnesses (Altekruse, 1997). It is also important that the raw ingredients be properly stored at the temperatures specified in their packages and expiration dates of processed food products must be checked and followed to avoid the use of spoiled materials (usda.gov, 2011).
2a. Describe the top recommendation you would give to the public to prevent being bit by mosquitoes that may transmit . Justify your answer.
The best way to prevent being bitten by a mosquito that may transmit the West Nile Virus is by using an insect repellent spray or lotion. The insect repellent lotion or spray should be applied only on the exposed skin when the neighbors intend to go outdoors or in an area where a West Nile virus incident was reported. Those who will be going out in the early mornings or in the evening must know how long they will be staying out. According to the US US EPA], the choice of repellent depends upon the duration of the protection that is needed (cdc.gov, 2012).
2b. Describe the top one recommendation you would give to the community to control the mosquito population in the community
The life cycle of a mosquito mostly depends on water. Primarily, it is where the female mosquito lays her eggs; and these eggs hatch only in the presence of water. The larvae and pupae also thrive in the water until they become adult mosquitoes (epa.gov, 2012). Knowing that mosquitoes need water in their life cycle, the best solution to control the mosquito population in the community is to remove unnecessary stagnant water in the area, especially areas near our homes. Swimming pools must be treated with chlorine to prevent mosquitoes from laying their eggs there. Flower pots, fountains and containers for the water of pets must be drained once a week. Buckets, covers, toys or other containers where there is stagnant water must be thrown into the garbage. Water in aquariums must be constantly running as well (epa.gov, 2012). These steps in preventing the mosquito population from growing do not require a huge amount of resources. Keeping the community clean and healthy is not only the local governments responsibility but goes down to each individual in the neighborhood.

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Increase in Heart-Rate due to the Effect of Push-Ups university essay helpThe paper Increase in Heart-Rate due to the Effect of Push-Ups as a Simple Rhythmic Exercise” is a potent example of a lab report on health sciences & medicine. In the current study, two students were observed for changes in heart rate before and after physical exercise, push-ups in this case. The heart rate and respiratory rate were found to be increased in these students which are a positive trend in response to the physical exertion is due to exercise. However, the true significance lies in the fact that this finding can be extrapolated to people with heart disease, who show sustained increased heart rate and (Jouven et al. 2005).HypothesisMy hypothesis is that performing pushups as a simple rhythmic exercise can increase autonomic nervous activities such as the heart rate and respiratory rate.
We are using two sets of data that are being compared with each other over a period of time. In such a case, bar graphs are best suited for effectively bringing out the information. Graph 1 shows the Heart Rate measured in two students prior to and after physical exercise (push-ups). An increase in the Heart Rate is observed in the students. Student 2 showed an increased Heart Rate of 0.733 after push-ups in comparison to 0.068 before exercise. Graph 2 shows the Respiratory Rate before and after physical exercise (push-ups).
As with the Heart Rate, this also shows an increase in both the students. Student 1 showed an increase from 26 per min to 46 per min, while Student 2 showed an increase from 13 per min to 34 per min. Discussion The article I summarized was Control of Heart Rate by the Autonomic Nervous System: Studies in Man on the Interrelation between Baroreceptor Mechanisms and Exercise (Robertson et al., 1966). The results of my study show that the heart rate and respiratory rate does increase post physical exercise such as push-ups.
The summarized article showed similar results in that the autonomic nervous activity including heart rate showed a marked increase from that at rest to exercise at a supine position and postural changes (Robertson et al. 1966). Physical exercise such as push-ups as in my study changes the in the autonomic nervous system such as heart rate and respiratory rate. This is comparable with the study conducted by Robertson et al. (1966), which also proved that cardiac performance during exercise is adjusted, in this case, increased to the metabolic demand.
As with the studies of Robertson et al. (1966), the increase in heart rate is in response to the metabolic needs of the exercise, push-ups, in this case, performed. In such cases the increase in heart rate in is positive but the sustained increased heart rate can be dangerous. Thus the application of this study can also be extended to prediction of sudden death in people with underlying heart disease (Jouven et al. 2005). In such persons often the heart rate recovery post-exercise is poor and this can be used as an indication of risk towards sudden death.
Studies of Sandvik et al. (1995) also show that resting heart rate and are associated with heart mortality. The significance of my study is that pushups as a form of physical exercise can be used to condition the heart rate in persons with underlying heart disease, thereby showing significant improvements in such patients. (Coats et al. 1992). The results of my study were as expected and comparable to the study by Robertson et al. 1966 in showing a marked increase in heart rate and respiratory rate.
The study could be improved by and those with marked heart disease to extrapolate the findings of this study into predicting sudden death for people with sustained increased heart rate (Jouven, 2005).

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Our essay writers are graduates with bachelor’s, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
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Predicting Health Professionals Teaching Commitment descriptive essay help: descriptive essay helpThe paper “Predicting Health Professionals Teaching Commitment in a Private Hospitals Training Program” is a great example of a research proposal on health sciences and medicine.Private hospitals are primarily business organizations that deliver particular kinds of service for a fee. Investments are provided by stockholders and other patrons who also expect returns of their investments in a specific period of time. Continuity of a hospitals success of gaining profit, or at least of customers patronage, depends significantly on the competence of the hospitals human resource, the nurses, doctors, and staff that are in the forefront of providing medical care to the hospitals patients.
Training of budding healthcare professionals cannot do without . Although the theoretical background provided by medical school training is fundamental, the ability to properly use this knowledge on actual patients can only be acquired through internship and hospital training. Individuals fresh from medical, nursing and allied medical schools thus look for the best training programs in order to hone their craft. Thus, concentrating on improving staff training not only improves the medical care currently provided by the hospital but also ensures the continuity of the hospitals optimal service by luring the most promising recruits to establish their careers in the hospital.
In effect, hospitals depend on senior professionals, not only to provide healthcare, but also to facilitate the hospitals training program. In effect, the viability of a private hospital as a business organization depends highly on the quality of commitment of these senior professionals to become clinical teachers. Specialists, like all teachers in educational institutions, must devote time and expertise to fulfill the schools teaching goals and, in the case of residency training, implement its declared training program.
However, both as practitioners and presumably as teachers, healthcare professionals are largely independent in the conduct of their business based on the structure of the professional organization which inherently gives them considerable control over their own work due to their set skills and knowledge. Doctors, for example, cannot be told upon how to treat or how to train, because within the hospital they are already the ones regarded as experts. With the lack of controlling body looking over the conduct of professionals, identifying the work-related factors that influence the consultants commitment to teaching is an important step in improving the quality of the hospitals training program, quality of care and recruitment strategy.
Purpose of research As mentioned above, senior professionals are depended upon by their hospitals of affiliation not only to provide healthcare to their patients but to train the incoming breed of healthcare professionals. Because these seniors are themselves primarily trained to be healthcare providers, clinical teaching becomes an added burden, especially for those who do not really have a passion for teaching. The hospital should thus put in place encouraging and limit the that influence the commitment of senior professionals to teach in the hospitals training program, especially with the absence of controlling body that can oversee these experts conduct of their business.
Identification of these factors can guide the formulation of strategies that can improve the program. Aspects of the study The study will focus on fulfilling the following objectives in order to answer the research question. The general objective of this study will be to determine the work-related factors perceived to influence the senior professionals commitment to the training program of a private hospital. Specifically, it will aim to: 1. Determine whether the reputation of a hospitals training program is a factor for graduating medical, nursing or allied medical students in deciding which hospital to enter to for internship. 2. Assess the current commitment of the senior professionals to the training program of the hospital. 3. Identify which of the work-related factors predict the commitment to teach in the residency training program of the hospital. OutlineI. Introduction A.
Aside from medical care, hospitals also aim to establish their training programs not only to ensure continuity of staff competency but also to recruit younger professionals into the hospital. B. A private hospital is a professional organization where specialists have considerable control over their activity. C. Since senior professionals are primary healthcare providers, teaching is an additional responsibility that needs to be encouraged in the absence of mandate needed to enforce it. II. Body A.
Factors influencing the graduating medical, nursing or allied medical students decision of which hospital to enter for an internship. B. The organizational commitment of senior professionals 1. To provide medical care 2. To train its new staff 3. To implement its rules and regulations C. the commitment to teach in the residency training program of the hospital. 1. .

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Psychology
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Engineering
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Nursing
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Sociology
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Business
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Statistics
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Our essay writers are graduates with bachelor’s, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
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Patients in Healthcare Quality Improvement argumentative essay help online: argumentative essay help onlineThe paper Role of Regulatory Bodies, Clinicians and Patients in ” is a forceful example of a term paper on health sciences & medicine. The provision of quality health services is fundamental to the success of any society; the government, development agents, experts as well as a society play an important role in promoting quality health. Quality health requires various pertinent tools and resources for instance: Technology, qualified personnel, and financial resources form the imperative components of health improvements.
The Foundational Frameworks for There are various fundamental designs that are formulated and implemented by various stakeholders to facilitate quality health improvement. These designs vary in their level of efficacy as well as the number of resources needed for their successful implementation. To begin, stakeholder such as the government has been increasingly applying the concept of partnerships as a framework for improving quality health provision. This more like a collaborative approach whereby stakeholders such as health specialists and local communities work partnership in the identification of health problems and formulating effective solutions.
Another framework that plays an important role in improving quality in the health sector is the research and innovation; this involves the provision of a platform to various stakeholders to develop new ideas and concepts that can facilitate the provision of quality health to the society. Governments, donors and various communities can play a great role in promoting research and innovation in the health sector through the provision of resources such as; finances, technology, and human resources.
Stakeholder definition of Quality in the Health Sector Various stakeholders have different perceptions and descriptions about quality in the dimension of health for instance: The Council of Medical Specialists Societies in the United States of America defines quality health as; the efficient delivery of health services by application of appropriate technology and the promotion of transparency. The Council of Medical Specialist Societies (CMSS) also connotes that quality health involves the provision of health services at an affordable price as well as health incentive to the populace.
On the other hand, various recipients of health services define quality health as the provision of effective, affordable and . Roles of Clinicians and Patients in Quality Improvement Clinicians play important roles in improving quality health provision by providing quality services to the patients after acquiring effective health knowledge and skills through training and research as well as innovation. On the other hand, patients may assist in quality health improvement through identification of various challenges that affect society; these challenges are presented to health experts who conduct research to develop solutions.
Importance of Quality Management in the Health Sector Quality management is imperative in all aspects of health provision in the sense that it reduces mortality rates in various health institutions; quality management strives to reduce deaths through research and innovation that focuses on the development of appropriate health care services which are more efficient and affordable in nature. Additionally, quality management focuses on ensuring affordability; this is achieved through the sustainable management of an institutions resources such as finances, technology, and human resources.
The sustainable resources reduce the costs associated with health service provision hence increasing affordability. The Pertinent Areas Monitored to ensure Quality To begin with, the most pertinent area that should be properly managed to ensure quality is the research and innovation sector; constant monitoring is imperative in the research and innovation sector to ensure that quality ideas and technologies are presented in the health sector to quality improvement. Secondly, it is important to constantly monitor health care policies of individual health centers to ensure that they comply with the set universal health care standards that promote quality.
It is also imperative to monitor utilization of resources such as finances, technology as well as human resources to ensure that the person concerned to adhere to the stipulated policies and promote sustainability.Roles of various Regulatory Bodies in an important role in the formulation and implementation of rules and regulation that are geared towards ensuring quality in health service provision. Additionally, organizations such as the Care and Social Services Inspectorate of Wales conduct pertinent regulatory roles in the health sector to promote quality social care services.
Organizations that Influence Quality ImprovementsAmong the imperative bodies that influence quality improvement in the health sector are health associations for instance: The American Public Health Association which has been active in conducting training programs, standardization, and stipulation of policies that are geared towards improving quality. Other organizations are the and other health associations that focus on research and innovation that are directed towards promoting quality.
ConclusionQuality health care provision is imperative in promoting development in various dimensions of the society; this requires a combination of various resources as well as skills and knowledge from myriad fields. It is therefore important for all stakeholders such as governments and other health specialists to take into consideration the different aspects of quality improvement such as; research and innovation, partnerships, top-bottom approach in the provision of health solutions and development of appropriate health policies.

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Finance
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Computer science
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Psychology
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Engineering
Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.
Nursing
In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.
Sociology
Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.
Business
We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!
Statistics
We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.
Law
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Our essay writers are graduates with bachelor’s, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
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Effects of Building Homes and Business on Flood Plains nursing essay helpThe world has experienced deadly floods and with property damage in different areas located along sea and ocean lines. Rivers and flash floods combined with landslides in countries like Brazil pose serious risks to people, infrastructure, and businesses (Jha, Bloch & Lamond, 2012). Indirect consequences of building homes and businesses in such areas include losses from business interruption as well as increased burdens on the public and household budgets. Business interruption increased travel time and costs and loss of income are indirect impacts that are often more difficult to quantify, and yet represent a significant proportion of the overall damage to communities.
The release of contaminants poses serious public risks for survivors of floods. Floodwaters can mix with raw sewage and thus dramatically increase the incidence of water-borne diseases (Jha, Bloch & Lamond, 2012). Zoning ordinance infringes on individual rights to use their property in the way they wish to without limitation. The zoning ordinance prevents the construction of homes in some areas for ecological reasons, especially along shorelines and flood areas. Zoning ordinance can be improved through the inclusion of where the concept is applied.
National/International AgenciesThe International Union for Conservation of Nature (IUCN) is among the worlds first global environment focused on promoting environmental conservation around the globe. IUCN was established in 1948 and has developed command significant recognition in environmental and sustainable development. The organization has over as well as over 11, 000 voluntary scientists and experts around the world (IUCN, 2012). IUCN has realized that population levels, growth, and distribution continue to overload the capacity of the environment in many regions across the globe.
Rapid population growth, among other factors, has contributed to the disruption of biodiversity. In this case, land and water use and spatial planning should bring a balanced distribution of population through, for example, incentives for industrial location, and for resettlement and development of , keeping in view the capacities of the environment (IUCN, 2012). In line with the promotion of diversity across the globe, IUCN has participated in activities aimed at controlling population growth in different parts of the world.
IUCN has initiated numerous conservation projects with some of the projects including the establishment of protected areas to prevent human settlements in such areas. This move is important in ensuring sustainability in the management of biodiversity (IUCN, 2012). IUCN functions can be applied in public health to prevent the settlement of people in areas vulnerable to environmental-related disasters such as floods and landslides. Overcrowding of people in a given area can also result in public health concerns such as which may be controlled through pollution and population growth.

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Literature
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Engineering
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Statistics
We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.
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What discipline/subjects do you deal in?
We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.
Are your writers competent enough to handle my paper?
Our essay writers are graduates with bachelor’s, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
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Profiling and Methods of Police Interrogations college essay help free: college essay help freeAS Description:It is important to be able to be aware of and distinguish among the types of profiling, the methods of police interrogations and the role of the psychologist in treating police officers with mental health concerns. The following questions will address the psychological concerns to promote a safe working environment for police officers.
AS Instructions:Respond to the following 3 questions with a minimum word count of 300 for each question. Copy and paste the question and then create your response. Be thorough with each question and use factual connections with your responses. Create your response in a word document and include APA reference citations at the end of your response.
1. Choose two commonly used psychological tests or inventories used in any law enforcement position. Describe the instrument, including what the test measures and what we know about its validity.
2. Discuss two factors that may contribute to the lack of women in law enforcement.
3. Select any 2 police psychology organizations and fully explain the organization and include the hyperlink.

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Online Academic Help With Different Subjects
Literature
Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.
Finance
Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.
Computer science
Computer science is a tough subject. Fortunately, our computer science experts are up to the match. No need to stress and have sleepless nights. Our academic writers will tackle all your computer science assignments and deliver them on time. Let us handle all your python, java, ruby, JavaScript, php , C+ assignments!
Psychology
While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.
Engineering
Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.
Nursing
In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.
Sociology
Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.
Business
We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!
Statistics
We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.
Law
Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.
What discipline/subjects do you deal in?
We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.
Are your writers competent enough to handle my paper?
Our essay writers are graduates with bachelor’s, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
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Association between Body Mass Index and Sleep free college essay helpThe paper The Association between and Its Effect on Sleep” is a pathetic example of a literature review on health sciences & medicine. Numerous researches have been done in order to establish the cross-sectional relationship between the effects of (BMI) on sleep among adults. Various results have been obtained whereby there are reports indicating that people with BMI, which ranges from one to three experience shorter sleep. Moreover, there is a high possibility that establishes a relationship of reduced duration of sleep with cases of obesity (Cappuccio, Taggart, Kandala, Currie, Peile, Stranges, & Miller, 2008, 626).
In fact, this issue is raising the interest of numerous researchers and the public. Nevertheless, there are critical gaps related to epidemiologic evidence, which has been gathered to understand the relationship between BMI and duration of sleep.On the other hand, other studies have indicated the effects of BIM on the sleep duration are based on sex, though this argument does not have a consistent direction of the difference. For instance, a negative relationship exists between sleep duration and BMI among men, though women indicate a U-shaped relationship (Wheaton, Perry, Chapman, McKnight-Eily, Presley-Cantrell & Croft, 2011, 1).
Nevertheless, Grandner and Drummond (2007, 67) suggested that there are to the significance of having a long sleep duration. Moreover, these claims were made citing evidence concerning the role of sleep duration as a risk factor associated with mortality. The relationship between duration of sleep and BMI has been regarded as one of the classifications of the mechanisms applied in the determination of the relationship between duration of sleep and mortality (Grandner & Drummond, 2007, 67).
Therefore, this creates a critical distinction, which is apprised through the state of evidence, which can be identified through more research in this field. In addition, BIM has been applied as a reliable predictor of the duration of sleep together with other factors such as age, gender, and ethnicity (Grandner & Drummond, 2007, 67). Duration of sleep is estimated by identifying the level of BMI, whereby the relationship between these variables is applied in days that are associated with inadequacy of sleep (Taheri, Lin, Austin, Young & Mignot, 2004, 62).
On the other hand, there is a comparison, which is applied in various studies relating to the self-report regarding sleep duration and daytime sleep. In this case, information gathered through this reports is applied in fostering a better understanding of the relationship between BMI and duration of sleep (Lauderdale, Knutson, Rathouz, Yan, Hulley & Liu, 2009, 805). Nevertheless, application of sleep duration as a means of measuring the effects of BMI on sleep has been faced by a drawback of failing to identify the quality of sleep.
In fact, there are chances that people who spend relatively long duration sleeping have a chance of not getting quality sleep due to disruptions or other sleep disorders such as insomnia. However, numerous studies have compared durations of self-report of sleep, thereby establishing the objectivity of measuring duration of sleep, which is depicted through reports of poor quality of sleep. In conclusion, the paper explores the relationship between BMI and the duration of sleep, whereby results from different studies have depicted a strong relationship between duration that is attributed to inadequate sleep and the levels of BMI.
Moreover, there are other effects of the weight on sleep that are considered to be ways of addressing sleep disorders, which poses the effects of sleep inadequacy. In fact, BMI can be considered as a way of approaching this issue through a weight reduction program.

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Online Academic Help With Different Subjects
Literature
Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.
Finance
Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.
Computer science
Computer science is a tough subject. Fortunately, our computer science experts are up to the match. No need to stress and have sleepless nights. Our academic writers will tackle all your computer science assignments and deliver them on time. Let us handle all your python, java, ruby, JavaScript, php , C+ assignments!
Psychology
While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.
Engineering
Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.
Nursing
In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.
Sociology
Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.
Business
We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!
Statistics
We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.
Law
Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.
What discipline/subjects do you deal in?
We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.
Are your writers competent enough to handle my paper?
Our essay writers are graduates with bachelor’s, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
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Contraceptive Coverage on the Health Policy personal essay helpThe paper “Contraceptive Coverage on the Health Policy” is an exceptional example of a research paper on health sciences and medicine. The effects of adding contraceptive coverage on the for women between the ages of 18-44 yearsMost employed women belong to the highly active reproductive age. Therefore, they are typically faced with medical issues related to the lack of contraceptive use. This impact on the insurance covered by employers. Therefore, it is critical that employers consider adding contraceptive coverage on the health plan costs for women (Sobel & Stitzel, 1998). In the U. S, most employers have been mandated to provide insurance coverage plans for reversible medical contraceptives.
It is not only expected to increase access but also the provision of contraceptives in an even-handed way. Women would get a selection method that is more balanced and most appropriate for their needs and preferences regardless of the cost (Abma et al., 1997). Approach A lot of controversial perspectives have arisen in relation to the need for employers to . Thus, the rate at which both employers and women employees would save and spend more were assessed. This exercise would highlight how much saving can be obtained by the employee and the women.
It would be attained through the performance of a comparison between the costs before the contraceptive coverage and that likely to be incurred after coverage. They would include maternity charges and abortions for unintended pregnancy. It would be compared against the extra contraceptive cover costs. From a study performed by the Alan Guttmacher Institute (AGI) (1994), it was found that the employers would need to add $ 21.40 to the insurance premiums. It comprises employer costs of $ 17.12 and employee costs of $ 4.28. However, owing to the unique payment of the contraceptive fund, it is quite difficult to estimate the estimated cost of reliable coverage (Henshaw, 1998).
Results It is found that in order for the full range, coverage of reversible medical contraceptives to be attained in health plans that do not cover them currently, the costs for both the employees and their dependents will increase. It will need to be covered by both the employers and employees as shown in table 1 below. 2. Thus, adding contraceptive coverage will decrease healthcare costs by $ 24 per women between 18 and 44 per year. The employer will save 1.5%. Number of Pregnant Women 500 Before coverage500 women pregnant No of unintended Pregnancies 185Percentage 37%Total Cost 12879×185=$2382615 After Coverage 500 women pregnantNo of .
5%Total Cost 168×8827=$1478522 Employers savings= 2382615-1478522.5==$904,092 Assumptions and limitations It is assumed that with the full range coverage of contraceptives, women employees will be able to access the most appropriate contraceptive depending on their needs irrespective of their cost. As such, they will reduce the need to on medical issues that arise owing to the lack of use of contraceptives. The added costs amount to $ 1.43 per month, which indicates less than a 1.
5 % increase in the employers cost. In this way, employers will save on the costs on standard healthcare insurance coverage (Laundry & Forrest, 1996). Conclusion Employees would benefit from this coverage since they will be able to reduce the Medicaid expenses caused by the lack of use of contraception by 1.5%. The rate of pregnancies dropped by about 3.5% and the cost by about $3 per person. The saving rate thus takes place in the ratio of 3:1.

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Online Academic Help With Different Subjects
Literature
Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.
Finance
Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.
Computer science
Computer science is a tough subject. Fortunately, our computer science experts are up to the match. No need to stress and have sleepless nights. Our academic writers will tackle all your computer science assignments and deliver them on time. Let us handle all your python, java, ruby, JavaScript, php , C+ assignments!
Psychology
While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.
Engineering
Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.
Nursing
In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.
Sociology
Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.
Business
We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!
Statistics
We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.
Law
Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.
What discipline/subjects do you deal in?
We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.
Are your writers competent enough to handle my paper?
Our essay writers are graduates with bachelor’s, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
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Leading Cause of Absenteeism in Schools Report college application essay help online: college application essay help onlineThe paper ‘Asthma: a Leading Cause of Absenteeism in Schools’ is an excellent example of a research proposal on health science and medicine.Asthma is a respiratory condition that compromises the functionality of the airway through obstruction associated with continuous instances of breathlessness and wheezing. The condition is prevalent amongst the school-going children between the ages of 8 to 11 years. Researchers endeavor to provide a remedy to the situation by developing medicines to curb the condition effectively. However, the condition has shown its persistence in spite of the ongoing research to mitigate it. This research intends to determine the predetermined hypothesis outlining that Asthma is the leading cause of absenteeism in schools and the third reason for hospitalizations in children (Houser, 2014).
This is quantitative research as it gives a clear relationship between the variables relevant to the issue of discussion. In this case, the descriptive date bringing out the relationships between the demographic factors such as age and race to be influential in the determination of asthma in an individual. The research also gives out the numerical values pertaining to the collected data. According to the intention of the researcher, this is quasi-experimental research as it involves the guidance from the hypothesis. In addition, it is research on the science dealing with biological functionality in the respiratory system of school-age children.
The researcher specifically involved an experiment in finding out the clear picture of the study. As it stands out, there was the involvement of social interactions in which the investigator met with the children and their caretakers. As per the design, this research is classified as conclusive research as it gives data that is subject to quantitative analysis such as the descriptive data. This is conclusive research because it depends on large quantity samples and also is subject to quantitative analysis.
The researchers recruited their subjects based on age and gender. The were between the ages of 8 and 11. This was done as it carried the best sample to be used by the researchers. The independent variables according to this article are demographic factors such as gender, age, and race. The dependent variables are factors such as learning experiences, access to computer and family structure.
Asthma was the confounding variable. The confounding variables are those that lead to a problem since it is empirically connected to both the dependent and independent variables. This is the type of variable that is understood as a variable rather than that with the possibility of being a problem. The participants in the study included children, parents and research groups. The accessible population was the participants included while the target population was the participants not included in the study. The target population was not included because they were not accessible during the study.
Measurement tools
Assessment center: this is an online tool for obtaining the patient data safely together with the capability to include customized instruments.
Atlas of IBHC: embraces the faculty of assimilated interactive health care determination.
Education Resources Information Center: The worlds biggest database of education materials including all documentation and journal resources.
Google and or Yahoo: the search engine on the internet.
: for clinical nurses as well as documents providing explanations of research tools, clinical evaluation tools, psychosomatic tests, and approach measures.
The research biases identified by the authors were selection bias and publication bias. The selection bias can result in the process of identification of the population to study. There are also significant problems in the identification of unpublished studies.
Selection bias or effect is the selection of entities, groups or information for evaluation such that appropriate randomization is not attained, in so doing making sure that the sample acquired is not demonstrative of the population anticipated to be investigated (Houser, 2014).
Controlling bias
Reflexivity: refers to the researchers personal reconsiderations of notions together with the predispositions (Houser, 2014).
Negative case sampling that demands purposively search for and, if available, sensibly scrutinize cases that criticize your anticipations.
The authors never realized the confirmation bias experienced and presumed that it was a social skill that could boost credibility in the research (Houser, 2014).
Limitations
History threat: any occasion, apart from the premeditated treatment scenario, that results amid the pretest and posttest dimension and has an effect on the dependent variable. The researcher will never determine whether the realized disparity between the pretest and posttest is as a result of the treatment or the historic event since both events are confounded (Houser, 2014).
Maturation threat: in case the maturation effect is confounded than the alteration observed might never be determined from the pretest to posttest originates from the treatment or maturation.
Minimizing Measurement Errors
Identify the target populationProper design of a questionnaire to meet the desired criteriaAvoidance of interviewer biasMitigation of respondent biasElimination of processing errorsRoper interpretation of resultsBenchmarkingResults
Type of statistical analyses performed and Reasons
Correlation: to ascertain relationships between variables
ANOVA: to distinguish the means of groups after consideration of the variance
Regression: to determine the relationships between changes in variables
Analysis of descriptive data
Descriptive data can be analyzed through the evaluation of measures of central tendency that are means of explaining the central point of frequency dispersal of group data. The data can also be analyzed by determining how the scores are spread out.
Conclusion
This research has succeeded in confirming the alternative hypothesis besides realizing its sole objective. According to the evaluation provided herein, Asthma is the leading cause of absenteeism in schools and the third reason for hospitalizations in children (Houser, 2014). Research studies have shown that asthma is consistent in its mutation and prevalence amongst the children regardless of the inventions of the cure. Most children fail to go to school occasionally due to their asthmatic conditions (Houser, 2014).

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Online Academic Help With Different Subjects
Literature
Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.
Finance
Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.
Computer science
Computer science is a tough subject. Fortunately, our computer science experts are up to the match. No need to stress and have sleepless nights. Our academic writers will tackle all your computer science assignments and deliver them on time. Let us handle all your python, java, ruby, JavaScript, php , C+ assignments!
Psychology
While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.
Engineering
Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.
Nursing
In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.
Sociology
Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.
Business
We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!
Statistics
We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.
Law
Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.
What discipline/subjects do you deal in?
We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.
Are your writers competent enough to handle my paper?
Our essay writers are graduates with bachelor’s, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
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Childhood Experiences and Historical Trauma write my essay help2 research articles are required every week. Research articles must be sent via email to instructor no later than Friday at 6:00 pm.
Brief Summary of the class syllabus:
PSYC 4606-01 Adverse Childhood Experiences & Historical Trauma. This course is an introduction to the study of adverse childhood experiences (ACES) and its implications for the fields of social work, education, epigenetics, medical/health sciences and psychology. Emphasis is placed on the 10 categories of adverse childhood experiences and how the stress and trauma of adversity can be transferred through generations. This course is an intensive study of the impact that historical, collective and racial trauma have on physical health, psychological and societal outcomes.
Basically the instructor wants two articles every week I was not informed however she has allowed me to turn in what I’ve missed I need 7 articles 1 page in length each or more related to or dealing with trauma in children mostly. Below is the Aces Study you can use if need be but mostly you are picking the topic yourself and doing a small little research paper on it be sure to site the website you get your info from. I need 7 DIFFERENT article research papers. 7 DIFFERENT!

Research Article
Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study
Vincent J. Felitti, MD, FACP, Robert F. Anda, MD, MS, Dale Nordenberg, MD, David F. Williamson, MS, PhD, Alison M. Spitz, MS, MPH, Valerie Edwards, BA, Mary P. Koss, PhD, James S. Marks, MD, MPH
Background: The relationship of health risk behavior and disease in adulthood to the breadth of exposure to childhood emotional, physical, or sexual abuse, and household dysfunction during childhood has not previously been described.
Methods: A questionnaire about adverse childhood experiences was mailed to 13,494 adults who had completed a standardized medical evaluation at a large HMO; 9,508 (70.5%) responded. Seven categories of adverse childhood experiences were studied: psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned. The number of categories of these adverse childhood experiences was then compared to measures of adult risk behavior, health status, and disease. Logistic regression was used to adjust for effects of demographic factors on the association between the cumulative number of categories of childhood exposures (range: 0 7) and risk factors for the leading causes of death in adult life.
Results: More than half of respondents reported at least one, and one-fourth reported $2 categories of childhood exposures. We found a graded relationship between the number of categories of childhood exposure and each of the adult health risk behaviors and diseases that were studied (P , .001). Persons who had experienced four or more categories of childhood exposure, compared to those who had experienced none, had 4- to 12-fold increased health risks for alcoholism, drug abuse, depression, and suicide attempt; a 2- to 4-fold increase in smoking, poor self-rated health, $50 sexual intercourse partners, and sexually transmitted disease; and a 1.4- to 1.6-fold increase in physical inactivity and severe obesity. The number of categories of adverse childhood exposures showed a graded relationship to the presence of adult diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease. The seven categories of adverse childhood experiences were strongly interrelated and persons with multiple categories of childhood exposure were likely to have multiple health risk factors later in life.
Conclusions: We found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.
Medical Subject Headings (MeSH): child abuse, sexual, domestic violence, spouse abuse, children of impaired parents, substance abuse, alcoholism, smoking, obesity, physical activity, depression, suicide, sexual behavior, sexually transmitted diseases, chronic obstruc- tive pulmonary disease, ischemic heart disease. (Am J Prev Med 1998;14:245258) 1998 American Journal of Preventive Medicine
Department of Preventive Medicine, Southern California Perma- nente Medical Group (Kaiser Permanente), (Felitti) San Diego, California 92111. National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, (Anda, Williamson, Spitz, Edwards, Marks) Atlanta, Georgia 30333. Department of Pediatrics, Emory University School Medicine, (Nor–
denberg) Atlanta, Georgia 30333. Department of Family and Com- munity Medicine, University of Arizona Health Sciences Center, (Koss) Tucson, Arizona 85727.
Address correspondence to: Vincent J. Felitti, MD, Kaiser Perma- nente, Department of Preventive Medicine, 7060 Clairemont Mesa Boulevard, San Diego, California 92111.
245Am J Prev Med 1998;14(4) 0749-3797/98/$19.00 1998 American Journal of Preventive Medicine PII S0749-3797(98)00017-8

Introduction
Only recently have medical investigators in pri-mary care settings begun to examine associa-tions between childhood abuse and adult health risk behaviors and disease.15 These associations are important because it is now clear that the leading causes of morbidity and mortality in the United States6
are related to health behaviors and lifestyle factors; these factors have been called the actual causes of death.7 Insofar as abuse and other potentially damaging childhood experiences contribute to the development of these risk factors, then these childhood exposures should be recog- nized as the basic causes of morbidity and mortality in adult life.
Although sociologists and psychologists have published numerous articles about the frequency8 12 and long-term consequenc- es1315 of childhood abuse, understanding their rele- vance to adult medical problems is rudimentary. Fur- thermore, medical research in this field has limited relevance to most primary care physicians because it is focused on adolescent health,16 20 mental health in adults,20 or on symptoms among patients in specialty clinics.22,23 Studies of the long-term effects of child- hood abuse have usually examined single types of abuse, particularly sexual abuse, and few have assessed the im- pact of more than one type of abuse.5,24 28 Conditions such as drug abuse, spousal violence, and criminal activity in the household may co-occur with specific forms of abuse that involve children. Without measuring these household factors as well, long-term influence might be wrongly attributed solely to single types of abuse and the cumulative influence of multiple categories of adverse childhood experiences would not be assessed. To our knowledge, the relationship of adult health risk behaviors, health status, and disease states to childhood abuse and household dysfunction29 35 has not been described.
We undertook the Adverse Childhood Experiences (ACE) Study in a primary care setting to describe the long-term relationship of childhood experiences to important medical and public health problems. The ACE Study is assessing, retrospectively and prospec- tively, the long-term impact of abuse and household dysfunction during childhood on the following out- comes in adults: disease risk factors and incidence, quality of life, health care utilization, and mortality. In this initial paper we use baseline data from the study to provide an overview of the prevalence and interrelation of exposures to childhood abuse and household dys- function. We then describe the relationship between the number of categories of these deleterious child- hood exposures and risk factors and those diseases that
underlie many of the leading causes of death in adults.6,7,36,37
Methods Study Setting
The ACE Study is based at Kaiser Permanentes San Diego Health Appraisal Clinic. More than 45,000 adults undergo standardized examinations there each year, making this clinic one of the nations largest free-
standing medical evaluation centers. All en- rollees in the Kaiser Health Plan in San Diego are advised through sales literature about the services (free for members) at the clinic; after enrollment, members are ad- vised again of its availability through new- member literature. Most members obtain appointments by self-referral; 20% are re-
ferred by their health care provider. A recent review of membership and utilization records among Kaiser members in San Diego continuously enrolled between 1992 and 1995 showed that 81% of those 25 years and older had been evaluated in the Health Appraisal Clinic.
Health appraisals include completion of a standard- ized medical questionnaire that requests demographic and biopsychosocial information, review of organ sys- tems, previous medical diagnoses, and family medical history. A health care provider completes the medical history, performs a physical examination, and reviews the results of laboratory tests with the patient.
Survey Methods
The ACE Study protocol was approved by the Institu- tional Review Boards of the Southern California Per- manente Medical Group (Kaiser Permanente), the Emory University School of Medicine, and the Office of Protection from Research Risks, National Institutes of Health. All 13,494 Kaiser Health Plan members who completed standardized medical evaluations at the Health Appraisal Clinic between AugustNovember of 1995 and JanuaryMarch of 1996 were eligible to participate in the ACE Study. Those seen at the clinic during December were not included because survey response rates are known to be lower during the holiday period.38
In the week after visiting the clinic, and hence having their standardized medical history already completed, members were mailed the ACE Study questionnaire that included questions about child- hood abuse and exposure to forms of household dysfunction while growing up. After second mailings of the questionnaire to persons who did not respond to the first mailing, the response rate for the survey was 70.5% (9,508/13,494).
See related
Commentary on pages 354,
356, 361.
246 American Journal of Preventive Medicine, Volume 14, Number 4

A second survey wave of approximately the same number of patients as the first wave was conducted between June and October of 1997. The data for the second survey wave is currently being compiled for analysis. The methods for the second mail survey wave were identical to the first survey wave as described above. The second wave was done to enhance the precision of future detailed analyses on special topics and to reduce the time necessary to obtain precise statistics on follow-up health events. An overview of the total ACE Study design is provided in Figure 1.
Comparison of Respondents and Nonrespondents
We abstracted the completed medical evaluation for every person eligible for the study; this included their medical history, laboratory results, and physical find- ings. Respondent (n 5 9,508) and nonrespondent (n 5 3,986) groups were similar in their percentages of women (53.7% and 51.0%, respectively) and in their mean years of education (14.0 years and 13.6 years, respectively). Respondents were older than nonrespon- dents (means 56.1 years and 49.3 years) and more likely to be white (83.9% vs. 75.3%) although the actual magnitude of the differences was small.
Respondents and nonrespondents did not differ with regard to their self-rated health, smoking, other sub- stance abuse, or the presence of common medical conditions such as a history of heart attack or stroke, chronic obstructive lung disease, hypertension, or dia- betes, or with regard to marital status or current family, marital, or job-related problems (data not shown). The health appraisal questionnaire used in the clinic con-
tains a single question about childhood sexual abuse that reads As a child were you ever raped or sexually molested? Respondents were slightly more likely to answer affirmatively than nonrespondents (6.1% vs. 5.4%, respectively).
Questionnaire Design
We used questions from published surveys to construct the ACE Study questionnaire. Questions from the Con- flicts Tactics Scale39 were used to define psychological and physical abuse during childhood and to define violence against the respondents mother. We adapted four questions from Wyatt40 to define contact sexual abuse during childhood. Questions about exposure to alcohol or drug abuse during childhood were adapted from the 1988 National Health Interview Survey.41 All of the questions we used in this study to determine childhood experiences were introduced with the phrase While you were growing up during your first 18 years of life . . .
Questions about health-related behaviors and health problems were taken from health surveys such as the Behavioral Risk Factor Surveys42 and the Third Na- tional Health and Nutrition Examination Survey,43
both of which are directed by the Centers for Disease Control and Prevention. Questions about depression came from the Diagnostic Interview Schedule of the National Institute of Mental Health (NIMH).44 Other information for this analysis such as disease history was obtained from the standardized questionnaire used in the Health Appraisal Clinic. (A copy of the question- naires used in this study may be found at www.elsevier. com/locate/amepre.)
Figure 1. ACE Study design. *After exclusions, 59.7% of the original wave I sample (8,056/13,494) were included in this analysis.
Am J Prev Med 1998;14(4) 247

Defining Childhood Exposures
We used three categories of childhood abuse: psycho- logical abuse (2 questions), physical abuse (2 ques- tions), or contact sexual abuse (4 questions). There were four categories of exposure to household dysfunc- tion during childhood: exposure to substance abuse (defined by 2 questions), mental illness (2 questions), violent treatment of mother or stepmother (4 ques- tions), and criminal behavior (1 question) in the house- hold. Respondents were defined as exposed to a cate- gory if they responded yes to 1 or more of the questions in that category. The prevalence of positive responses to the individual questions and the category prevalences are shown in Table 1.
We used these 7 categories of childhood exposures to abuse and household dysfunction for our analysis. The measure of childhood exposure that we used was simply the sum of the categories with an exposure; thus the possible number of exposures ranged from 0 (unex- posed) to 7 (exposed to all categories).
Risk Factors and Disease Conditions Assessed
Using information from both the study questionnaire and the Health Appraisal Clinics questionnaire, we chose 10 risk factors that contribute to the leading causes of morbidity and mortality in the United States.6,7,36,37 The risk factors included smoking, severe obesity, physical inactivity, depressed mood, suicide attempts, alcoholism, any drug abuse, parenteral drug abuse, a high lifetime number of sexual partners ($50), and a history of having a sexually transmitted disease.
We also assessed the relationship between childhood exposures and disease conditions that are among the leading causes of mortality in the United States.6 The presence of these disease conditions was based upon medical histories that patients provided in response to the clinic questionnaire. We included a history of ischemic heart disease (including heart attack or use of nitroglycerin for exertional chest pain), any cancer, stroke, chronic bronchitis, or emphysema (COPD),
Table 1. Prevalence of childhood exposure to abuse and household dysfunction
Category of childhood exposurea Prevalence (%) Prevalence (%)
Abuse by category Psychological 11.1
(Did a parent or other adult in the household . . .) Often or very often swear at, insult, or put you down? 10.0 Often or very often act in a way that made you afraid that
you would be physically hurt? 4.8
Physical 10.8 (Did a parent or other adult in the household . . .)
Often or very often push, grab, shove, or slap you? 4.9 Often or very often hit you so hard that you had marks or
were injured? 9.6
Sexual 22.0 (Did an adult or person at least 5 years older ever . . .)
Touch or fondle you in a sexual way? 19.3 Have you touch their body in a sexual way? 8.7 Attempt oral, anal, or vaginal intercourse with you? 8.9 Actually have oral, anal, or vaginal intercourse with you? 6.9
Household dysfunction by category Substance abuse 25.6
Live with anyone who was a problem drinker or alcoholic? 23.5 Live with anyone who used street drugs? 4.9
Mental illness 18.8 Was a household member depressed or mentally ill? 17.5 Did a household member attempt suicide? 4.0
Mother treated violently 12.5 Was your mother (or stepmother)
Sometimes, often, or very often pushed, grabbed, slapped, or had something thrown at her?
11.9
Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard?
6.3
Ever repeatedly hit over at least a few minutes? 6.6 Ever threatened with, or hurt by, a knife or gun? 3.0
Criminal behavior in household Did a household member go to prison? 3.4 3.4
Any category reported 52.1% aAn exposure to one or more items listed under the set of questions for each category.
248 American Journal of Preventive Medicine, Volume 14, Number 4

diabetes, hepatitis or jaundice, and any skeletal frac- tures (as a proxy for risk of unintentional injuries). We also included responses to the following question about self-rated health: Do you consider your physical health to be excellent, very good, good, fair, or poor? because it is strongly predictive of mortality.45
Definition of Risk Factors
We defined severe obesity as a body mass index (kg/ meter2) $35 based on measured height and weight; physical inactivity as no participation in recreational physical activity in the past month; and alcoholism as a Yes response to the question Have you ever consid- ered yourself to be an alcoholic? The other risk factors that we assessed are self-explanatory.
Exclusions from Analysis
Of the 9,508 survey respondents, we excluded 51 (0.5%) whose race was unstated and 34 (0.4%) whose educational attainment was not reported. We also ex- cluded persons who did not respond to certain ques- tions about adverse childhood experiences. This in- volved the following exclusions: 125 (1.3%) for household substance abuse, 181 (1.9%) for mental illness in the home, 148 (1.6%) for violence against mother, 7 (0.1%) for imprisonment of a household member, 109 (1.1%) for childhood psychological abuse, 44 (0.5%) for childhood physical abuse, and 753 (7.9%) for childhood sexual abuse. After these exclu- sions, 8,056 of the original 9,508 survey respondents (59.7% of the original sample of 13,494) remained and were included in the analysis. Procedures for insuring that the findings based on complete data were gener- alizable to the entire sample are described below.
The mean age of the 8,506 persons included in this analysis was 56.1 years (range: 19 92 years); 52.1% were women; 79.4% were white. Forty-three percent had graduated from college; only 6.0% had not graduated from high school.
Statistical Analysis
We used the Statistical Analysis System (SAS)46 for our analyses. We used the direct method to age-adjust the prevalence estimates. Logistic regression analysis was employed to adjust for the potential confounding ef- fects of age, sex, race, and educational attainment on the relationship between the number of childhood exposures and health problems.
To test for a dose-response relationship to health problems, we entered the number of childhood expo- sures as a single ordinal variable (0, 1, 2, 3, 4, 5, 6, 7) into a separate logistic regression model for each risk factor or disease condition.
Assessing the Possible Influence of Exclusions
To determine whether our results were influenced by excluding persons with incomplete information on any of the categories of childhood exposure, we performed a separate sensitivity analysis in which we included all persons with complete demographic information but assumed that persons with missing information for a category of childhood exposure did not have an expo- sure in that category.
Results Adverse Childhood Exposures
The level of positive responses for the 17 questions included in the seven categories of childhood exposure ranged from 3.0% for a respondents mother (or stepmother) having been threatened with or hurt by a gun or knife to 23.5% for having lived with a problem drinker or alcoholic (Table 1). The most prevalent of the 7 categories of childhood exposure was substance abuse in the household (25.6%); the least prevalent exposure category was evidence of criminal behavior in the household (3.4%). More than half of respondents (52%) experienced $1 category of adverse childhood exposure; 6.2% reported $4 exposures.
Relationships between Categories of Childhood Exposure
The probability that persons who were exposed to any single category of exposure were also exposed to an- other category is shown in Table 2. The relationship between single categories of exposure was significant for all comparisons (P , .001; chi-square). For persons reporting any single category of exposure, the proba- bility of exposure to any additional category ranged from 65% (median: 80%); similarly, the probabil- ity of $2 additional exposures ranged from 40% (median: 54.5%).
The number of categories of childhood exposures by demographic characteristics is shown in Table 3. Statis- tically, significantly fewer categories of exposure were found among older persons, white or Asian persons, and college graduates (P , .001). Because age is associated with both the childhood exposures as well as many of the health risk factors and disease outcomes, all prevalence estimates in the tables are adjusted for age.
Relationship between Childhood Exposures and Health Risk Factors
Both the prevalence and risk (adjusted odds ratio) increased for smoking, severe obesity, physical inactiv- ity, depressed mood, and suicide attempts as the num- ber of childhood exposures increased (Table 4). When
Am J Prev Med 1998;14(4) 249

persons with 4 categories of exposure were compared to those with none, the odds ratios ranged from 1.3 for physical inactivity to 12.2 for suicide attempts (Table 4).
Similarly, the prevalence and risk (adjusted odds ratio) of alcoholism, use of illicit drugs, injection of illicit drugs, $50 intercourse partners, and history of a sexually transmitted disease increased as the number of childhood exposures increased (Table 5). In compar- ing persons with $4 childhood exposures to those with none, odds ratios ranged from 2.5 for sexually trans- mitted diseases to 7.4 for alcoholism and 10.3 for injected drug use.
Childhood Exposures and Clustering of Health Risk Factors
We found a strong relationship between the number of childhood exposures and the number of health risk factors for leading causes of death in adults (Table 6). For example, among persons with no childhood expo- sures, 56% had none of the 10 risk factors whereas only 14% of persons with $4 categories of childhood expo- sure had no risk factors. By contrast, only 1% of persons with no childhood exposures had four or more risk factors, whereas 7% of persons with $4 childhood exposures had four or more risk factors (Table 6).
Relationship between Childhood Exposures and Disease Conditions
When persons with 4 or more categories of childhood exposure were compared to those with none, the odds ratios for the presence of studied disease con- ditions ranged from 1.6 for diabetes to 3.9 for chronic bronchitis or emphysema (Table 7). Simi- larly, the odds ratios for skeletal fractures, hepatitis or jaundice, and poor self-rated health were 1.6, 2.3, and 2.2, respectively (Table 8).
Significance of Dose-Response Relationships
In logistic regression models (which included age, gender, race, and educational attainment as covariates) we found a strong, dose-response relationship between the number of childhood exposures and each of the 10 risk factors for the leading causes of death that we studied (P , .001). We also found a significant (P , .05) dose-response relationship between the number of childhood exposures and the following disease con- ditions: ischemic heart disease, cancer, chronic bron- chitis or emphysema, history of hepatitis or jaundice, skeletal fractures, and poor self-rated health. There was no statistically significant dose-response relationship for a history of stroke or diabetes.T
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250 American Journal of Preventive Medicine, Volume 14, Number 4

Assessment of the Influence of Exclusions
In the sensitivity analysis where missing information for a category of childhood exposure was considered as no exposure, the direction and strength of the associations between the number of childhood exposures and the risk factors and disease conditions were nearly identical (data not shown). Thus, the results we present appear to be unaffected by our decision to exclude persons for whom information on any category of childhood expo- sure was incomplete.
Discussion
We found a strong dose response relationship between the breadth of exposure to abuse or household dysfunc- tion during childhood and multiple risk factors for several of the leading causes of death in adults. Disease conditions including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver dis- ease, as well as poor self-rated health also showed a graded relationship to the breadth of childhood expo- sures. The findings suggest that the impact of these adverse childhood experiences on adult health status is strong and cumulative.
The clear majority of patients in our study who were exposed to one category of childhood abuse or house- hold dysfunction were also exposed to at least one other. Therefore, researchers trying to understand the long-term health implications of childhood abuse may benefit from considering a wide range of related ad- verse childhood exposures. Certain adult health out-
comes may be more strongly related to unique combi- nations or the intensity of adverse childhood exposures than to the total breadth of exposure that we used for our analysis. However, the analysis we present illustrates the need for an overview of the net effects of a group of complex interactions on a wide range of health risk behaviors and diseases.
Several potential limitations need to be considered when interpreting the results of this study. The data about adverse childhood experiences are based on self-report, retrospective, and can only demonstrate associations between childhood exposures and health risk behaviors, health status, and diseases in adulthood. Second, some persons with health risk behaviors or diseases may have been either more, or less, likely to report adverse childhood experiences. Each of these issues potentially limits inferences about causality. Fur- thermore, disease conditions could be either over- or under-reported by patients when they complete the medical questionnaire. In addition, there may be me- diators of the relationship between childhood experi- ences and adult health status other than the risk factors we examined. For example, adverse childhood experi- ences may affect attitudes and behaviors toward health and health care, sensitivity to internal sensations, or physiologic functioning in brain centers and neuro- transmitter systems. A more complete understanding of these issues is likely to lead to more effective ways to address the long-term health problems associated with childhood abuse and household dysfunction.
However, our estimates of the prevalence of child-
Table 3. Prevalence of categories of adverse childhood exposures by demographic characteristics
Characteristic Sample size (N)
Number of categories (%)a
0 1 2 3 4
Age group (years) 1934 807 35.4 25.4 17.2 11.0 10.9 3549 2,063 39.3 25.1 15.6 9.1 10.9 5064 2,577 46.5 25.2 13.9 7.9 6.6 $65 2,610 60.0 24.5 8.9 4.2 2.4
Genderb
Women 4,197 45.4 24.0 13.4 8.7 8.5 Men 3,859 53.7 25.8 11.6 5.0 3.9
Raceb
White 6,432 49.7 25.3 12.4 6.7 6.0 Black 385 38.8 25.7 16.3 12.3 7.0 Hispanic 431 42.9 24.9 13.7 7.4 11.2 Asian 508 66.0 19.0 9.9 3.4 1.7 Other 300 41.0 23.5 13.9 9.5 12.1
Educationb
No HS diploma 480 56.5 21.5 8.4 6.5 7.2 HS graduate 1,536 51.6 24.5 11.3 7.4 5.2 Any college 2,541 44.1 25.5 14.8 7.8 7.8 College graduate 3,499 51.4 25.1 12.1 6.1 5.3 All participants 8,056 49.5 24.9 12.5 6.9 6.2
aThe number of categories of exposure was simply the sum of each of the seven individual categories that were assessed (see Table 1). bPrevalence estimates adjusted for age.
Am J Prev Med 1998;14(4) 251

hood exposures are similar to estimates from nationally representative surveys, indicating that the experiences of our study participants are comparable to the larger population of U.S. adults. In our study, 23.5% of participants reported having grown up with an alcohol abuser; the 1988 National Health Interview Survey estimated that 18.1% of adults had lived with an alcohol abuser during childhood.41 Contact sexual abuse was reported by 22% of respondents (28% of women and 16% of men) in our study. A national telephone survey of adults in 1990 using similar criteria for sexual abuse estimated that 27% of women and 16% of men had been sexually abused.12
There are several reasons to believe that our esti- mates of the long-term relationship between adverse childhood experiences and adult health are conserva- tive. Longitudinal follow-up of adults whose childhood abuse was well documented has shown that their retro- spective reports of childhood abuse are likely to under-
estimate actual occurrence.47,48 Underestimates of childhood exposures would result in downwardly bi- ased estimates of the relationships between childhood exposures and adult health risk behaviors and dis- eases. Another potential source of underestimation of the strength of these relationships is the lower number of childhood exposures reported by older persons in our study. This may be an artifact caused by premature mortality in persons with multiple adverse childhood exposures; the clustering of mul- tiple risk factors among persons with multiple child- hood exposures is consistent with this hypothesis. Thus, the true relationships between adverse child- hood exposures and adult health risk behaviors, health status, and diseases may be even stronger than those we report.
An essential question posed by our observations is, Exactly how are adverse childhood experiences linked to health risk behaviors and adult diseases? The link-
Table 4. Number of categories of adverse childhood exposure and the adjusted odds of risk factors including current smoking, severe obesity, physical inactivity, depressed mood, and suicide attempt
Health problem
Number of categories
Sample size (N)a
Prevalence (%)b
Adjusted odds ratioc
95% confidence interval
Current smokerd 0 3,836 6.8 1.0 Referent 1 2,005 7.9 1.1 ( 0.91.4) 2 1,046 10.3 1.5 ( 1.11.8) 3 587 13.9 2.0 ( 1.52.6)
4 or more 544 16.5 2.2 ( 1.72.9) Total 8,018 8.6
Severe obesityd
(BMI $ 35) 0 3,850 5.4 1.0 Referent 1 2,004 7.0 1.1 ( 0.91.4) 2 1,041 9.5 1.4 ( 1.11.9) 3 590 10.3 1.4 ( 1.01.9)
4 or more 543 12.0 1.6 ( 1.22.1) Total 8,028 7.1
No leisure-time physical activity
0 3,634 18.4 1.0 Referent 1 1,917 22.8 1.2 ( 1.11.4) 2 1,006 22.0 1.2 ( 1.01.4) 3 559 26.6 1.4 ( 1.11.7)
4 or more 523 26.6 1.3 ( 1.11.6) Total 7,639 21.0
Two or more weeks of depressed mood in the past year
0 3,799 14.2 1.0 Referent
1 1,984 21.4 1.5 ( 1.31.7) 2 1,036 31.5 2.4 ( 2.02.8) 3 584 36.2 2.6 ( 2.13.2)
4 or more 542 50.7 4.6 ( 3.85.6) Total 7,945 22.0
Ever attempted suicide 0 3,852 1.2 1.0 Referent 1 1,997 2.4 1.8 ( 1.22.6) 2 1,048 4.3 3.0 ( 2.04.6) 3 587 9.5 6.6 ( 4.59.8)
4 or more 544 18.3 12.2 (8.517.5) Total 8,028 3.5
aSample sizes will vary due to incomplete or missing information about health problems. bPrevalence estimates are adjusted for age. cOdds ratios adjusted for age, gender, race, and educational attainment. dIndicates information recorded in the patients chart before the study questionnaire was mailed.
252 American Journal of Preventive Medicine, Volume 14, Number 4

ing mechanisms appear to center on behaviors such as smoking, alcohol or drug abuse, overeating, or sexual behaviors that may be consciously or unconsciously used because they have immediate pharmacological or psychological benefit as coping devices in the face of the stress of abuse, domestic violence, or other forms of
family and household dysfunction. High levels of expo- sure to adverse childhood experiences would expect- edly produce anxiety, anger, and depression in chil- dren. To the degree that behaviors such as smoking, alcohol, or drug use are found to be effective as coping devices, they would tend to be used chronically. For
Table 5. Number of categories of adverse childhood exposure and the prevalence and risk (adjusted odds ratio) of health risk factors including alcohol or drug abuse, high lifetime number of sexual partners, or history of sexually transmitted disease
Health problem
Number of categories
Sample size (N)a
Prevalence (%)b
Adjusted odds ratioc
95% confidence interval
Considers self an alcoholic
0 3,841 2.9 1.0 Referent 1 1,993 5.7 2.0 (1.62.7) 2 1,042 10.3 4.0 (3.05.3) 3 586 11.3 4.9 (3.56.8) 4 or more 540 16.1 7.4 (5.410.2)
Total 8,002 5.9 Ever used illicit drugs 0 3,856 6.4 1.0 Referent
1 1,998 11.4 1.7 (1.42.0) 2 1,045 19.2 2.9 (2.43.6) 3 589 21.5 3.6 (2.84.6) 4 or more 541 28.4 4.7 (3.76.0)
Total 8,029 11.6 Ever injected drugs 0 3,855 0.3 1.0 Referent
1 1,996 0.5 1.3 (0.63.1) 2 1,044 1.4 3.8 (1.88.2) 3 587 2.3 7.1 (3.315.5) 4 or more 540 3.4 10.3 (4.921.4)
Total 8,022 0.8 Had 50 or more intercourse partners
0 3,400 3.0 1.0 Referent 1 1,812 5.1 1.7 (1.32.3) 2 926 6.1 2.3 (1.63.2) 3 526 6.3 3.1 (2.04.7) 4 or more 474 6.8 3.2 (2.15.1)
Total 7,138 4.4 Ever had a sexually transmitted diseased
0 3,848 5.6 1.0 Referent 1 2,001 8.6 1.4 (1.11.7) 2 1,044 10.4 1.5 (1.21.9) 3 588 13.1 1.9 (1.42.5) 4 or more 542 16.7 2.5 (1.93.2)
Total 8023 8.2 aSample sizes will vary due to incomplete or missing information about health problems. bPrevalence estimates are adjusted for age. cOdds ratios adjusted for age, gender, race, and educational attainment. dIndicates information recorded in the patients chart before the study questionnaire was mailed.
Table 6. Relationship between number of categories of childhood exposure and number of risk factors for the leading causes of deatha
Number of categories Sample size
% with number of risk factors
0 1 2 3 4
0 3,861 56 29 10 4 1 1 2,009 42 33 16 6 2 2 1,051 31 33 20 10 4 3 590 24 33 20 13 7
$4 545 14 26 28 17 7 Total 8,056 44 31 15 7 3
aRisk factors include: smoking, severe obesity, physical inactivity, depressed mood, suicide attempt, alcoholism, any drug use, injected drug use, $50 lifetime sexual partners, and history of a sexually transmitted disease.
Am J Prev Med 1998;14(4) 253

example, nicotine is recognized as having beneficial psychoactive effects in terms of regulating affect49 and persons who are depressed are more likely to smoke.50,51 Thus, persons exposed to adverse child- hood experiences may benefit from using drugs such as nicotine to regulate their mood.49,52
Consideration of the positive neuroregulatory effects of health-risk behaviors such as smoking may provide biobehavioral explanations53 for the link between ad- verse childhood experiences and health risk behaviors and diseases in adults. In fact, we found that exposure to higher numbers of categories of adverse childhood experiences increased the likelihood of smoking by the age of 14, chronic smoking as adults, and the presence of smoking-related diseases. Thus, smoking, which is medically and socially viewed as a problem may, from the perspective of the user, represent an effective immediate solution that leads to chronic use. Decades later, when this solution manifests as emphysema, cardiovascular disease, or malignancy, time and the
tendency to ignore psychological issues in the manage- ment of organic disease make improbable any full understanding of the original causes of adult disease (Figure 2). Thus, incomplete understanding of the possible benefits of health risk behaviors leads them to be viewed as irrational and having solely negative consequences.
Because adverse childhood experiences are common and they have strong long-term associations with adult health risk behaviors, health status, and diseases, in- creased attention to primary, secondary, and tertiary prevention strategies is needed. These strategies in- clude prevention of the occurrence of adverse child- hood experiences, preventing the adoption of health risk behaviors as responses to adverse experiences during childhood and adolescence, and, finally, help- ing change the health risk behaviors and ameliorating the disease burden among adults whose health prob- lems may represent a long-term consequence of ad- verse childhood experiences.
Table 7. Number of categories of adverse childhood exposure and the prevalence and risk (adjusted odds ratio) of heart attack, cancer, stroke, COPD, and diabetes
Disease conditiond
Number of categories
Sample size (N)a
Prevalence (%)b
Adjusted odds ratioc
95% confidence interval
Ischemic heart disease 0 3,859 3.7 1.0 Referent 1 2,009 3.5 0.9 (0.71.3) 2 1,050 3.4 0.9 (0.61.4) 3 590 4.6 1.4 (0.82.4) 4 or more 545 5.6 2.2 (1.33.7)
Total 8,022 3.8 Any cancer 0 3,842 1.9 1.0 Referent
1 1,995 1.9 1.2 (1.01.5) 2 1,043 1.9 1.2 (1.01.5) 3 588 1.9 1.0 (0.71.5) 4 or more 543 1.9 1.9 (1.32.7)
Total 8,011 1.9 Stroke 0 3,832 2.6 1.0 Referent
1 1,993 2.4 0.9 (0.71.3) 2 1,042 2.0 0.7 (0.41.3) 3 588 2.9 1.3 (0.72.4) 4 or more 543 4.1 2.4 (1.34.3)
Total 7,998 2.6 Chronic bronchitis or emphysema
0 3,758 2.8 1.0 Referent 1 1,939 4.4 1.6 (1.22.1) 2 1,009 4.4 1.6 (1.12.3) 3 565 5.7 2.2 (1.43.3) 4 or more 512 8.7 3.9 (2.65.8)
Total 7,783 4.0 Diabetes 0 3,850 4.3 1.0 Referent
1 2,002 4.1 1.0 (0.71.3) 2 1,046 3.9 0.9 (0.61.3) 3 587 5.0 1.2 (0.81.9) 4 or more 542 5.8 1.6 (1.02.5)
Total 8,027 4.3 aSample sizes will vary due to incomplete or missing information about health problems. bPrevalence estimates are adjusted for age. cOdds ratios adjusted for age, gender, race, and educational attainment. dIndicates information recorded in the patients chart before the study questionnaire was mailed.
254 American Journal of Preventive Medicine, Volume 14, Number 4

Primary prevention of adverse childhood experi- ences has proven difficult54,55 and will ultimately re- quire societal changes that improve the quality of family and household environments during childhood. Recent research on the long-term benefit of early home visitation on reducing the prevalence of adverse childhood experi- ences is promising.56 In fact, preliminary data from the ACE Study provided the impetus for the Kaiser Health Plan to provide funding to participate at 4 locations (including San Diego County, California) in the Com- monwealth Funds Healthy Steps program. This pro- gram extends the traditional practice of pediatrics by adding one or more specialists in the developmental and psychosocial dimensions of both childhood and parent- hood. Through a series of office visits, home visits, and a telephone advice line for parents, these specialists develop close relationships between children and their families from birth to 3 years of age. This approach is consistent with the recommendation of the U.S. Advisory Board on Child Abuse and Neglect that a universal home visitation program for new parents be developed57,58 and provides an example of a family-based primary prevention effort that is being explored in a managed care setting. If these types of approaches can be replicated and implemented on a large scale, the long-term benefits may include, somewhat unexpectedly, substantial improvements in overall adult health.
Secondary prevention of the effects of adverse child- hood experiences will first require increased recogni- tion of their occurrence and second, an effective un-
derstanding of the behavioral coping devices that commonly are adopted to reduce the emotional impact of these experiences. The improbability of giving up an immediate solution in return for a nebulous long- term health benefit has thwarted many well-intended preventive efforts. Although articles in the general medical literature are alerting the medical community to the fact that childhood abuse is common,59 adoles- cent health care is often inadequate in terms of psycho- social assessment and anticipatory guidance.60 Clearly, comprehensive strategies are needed to identify and intervene with children and families who are at risk for these adverse experiences and their related out- comes.61 Such strategies should include increased com- munication between and among those involved in family practice, internal medicine, nursing, social work, pediatrics, emergency medicine, and preventive medi- cine and public health. Improved understanding is also needed of the effects of childhood exposure to domes- tic violence.19,62 Additionally, increased physician train- ing63 is needed to recognize and coordinate the man- agement of all persons affected by child abuse, domestic violence, and other forms of family adversity such as alcohol abuse or mental illness.
In the meantime, tertiary care of adults whose health problems are related to experiences such as childhood abuse5 will continue to be a difficult challenge. The relationship between childhood experiences and adult health status is likely to be overlooked in medical practice because the time delay between exposure
Table 8. Number of categories of adverse childhood exposure and the prevalence and risk (adjusted odds ratio) of skeletal fracture, hepatitis or jaundice, and poor self-rated health
Disease condition
Number of categories
Sample size (N)a
Prevalence (%)b
Adjusted odds ratioc
95% confidence interval
Ever had a skeletal fracture
0 3,843 3.6 1.0 Referent 1 1,998 4.0 1.1 (1.01.2) 2 1,048 4.5 1.4 (1.21.6) 3 587 4.0 1.2 (1.01.4) 4 or more 544 4.8 1.6 (1.32.0)
Total 8,020 3.9 Ever had hepatitis or jaundice
0 3,846 5.3 1.0 Referent 1 2,006 5.5 1.1 (0.91.4) 2 1,045 7.7 1.8 (1.42.3) 3 590 10.2 1.6 (1.22.3) 4 or more 543 10.7 2.4 (1.83.3)
Total 8,030 6.5 Fair or poor self-rated health
0 3,762 16.3 1.0 Referent 1 1,957 17.8 1.2 (1.01.4) 2 1,029 19.9 1.4 (1.21.7) 3 584 20.3 1.4 (1.11.7) 4 or more 527 28.7 2.2 (1.82.7)
Total 7,859 18.2 aSample sizes will vary due to incomplete or missing information about health problems. bPrevalence estimates are adjusted for age and gender. cOdds ratios adjusted for age, gender, race, and educational attainment. dIndicates information recorded in the patients chart before the study questionnaire was mailed.
Am J Prev Med 1998;14(4) 255

during childhood and recognition of health problems in adult medical practice is lengthy. Moreover, these childhood exposures include emotionally sensitive top- ics such as family alcoholism29,30 and sexual abuse.64
Many physicians may fear that discussions of sexual violence and other sensitive issues are too personal even for the doctor-patient relationship.65 For example, the American Medical Association recommends screen- ing of women for exposure to violence at every en- trance to the health system;66 however, such screening appears to be rare.67 By contrast, women who are asked about exposure to sexual violence say they consider such questions to be welcome and germane to routine medical care,68 which suggests that physicians fears about patient reactions are largely unfounded.
Clearly, further research and training are needed to help medical and public health practitioners under- stand how social, emotional, and medical problems are linked throughout the lifespan (Figure 2). Such re- search and training would provide physicians with the confidence and skills to inquire and respond to patients who acknowledge these types of childhood exposures. Increased awareness of the frequency and long-term consequences of adverse childhood experiences may also lead to improvements in health promotion and disease prevention programs. The magnitude of the difficulty of introducing the requisite changes into
medical and public health research, education, and practice can be offset only by the magnitude of the implications that these changes have for improving the health of the nation.
We thank Naomi Howard for her dedication to the ACE Study. This research is supported by the Centers for Disease Control and Prevention via cooperative agreement TS-44-10/12 with the Association of Teachers of Preventive Medicine.
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256 American Journal of Preventive Medicine, Volume 14, Number 4

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258 American Journal of Preventive Medicine, Volume 14, Number 4

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Multifunctionality of Technology in Healthcare write my essay help: write my essay helpThe paper Multifunctionality of Information Technology in Healthcare – Benefits for Healthcare Professionals and Patients” is an excellent example of a term paper on health sciences & medicine. A high number of Americans are highly hopeful that health information technology (HIT) will have positive effects not only on the lives of the patients but the doctors as well. Whereas doctors could use HIT to minimize medical errors, hospital registry and secretaries can use HIT systems to effectively save, access and share relevant patients information.
Furthermore, hospitals, companies, and governments could also save large amounts of money due to improved efficiency. In fact, researchers from RAND Corporation pointed out that a full application of HIT systems could result in an annual efficiency savings of up to $77 billion (2005). However, due to various reasons, the majority of health care providers are yet to fully adopt the HIT systems. In fact, there has been wide speculation that the implementation of HIT systems could even hamper patient care (Anderson et al., 2006). For this reason, it is of great importance to assess the impact of HIT on the quality of patient care.
Basically, HIT incorporates a wide range of new technological systems designed to manage a patients health-related information. Essentially, HIT systems electronically collect, organizes and stores information pertaining to the patients health thus leading to effective coordination of healthcare. The systems used to store this information are widely known as Electronic Health Records (EHR), although a few people refer to them as Electronic Medical Records (EMR). Basically, these systems come in different sizes and shapes, depending on their core functions.
For instance, whereas some EHR systems only collect and store data within a certain institution, others are integrated thus allowing them to not only collect and store data but to also supply the patients data across various medical facilities upon request (Blumenthal & Glaser, 2007). This factor has largely facilitated the reduction of medical errors since health practitioners have the ability to access the patients past medical data before carrying out an examination. Equally important, the Computerized Physician Order Entry (CPOE), is an imperative system that can be used in the general improvement of patient care.
Generally, this system enables health practitioners such as doctors and pharmacists to digitally carry out laboratory tests as well as order drug prescription electronically, factors that have largely resulted to reduced medical errors emanating from . In addition, the CPOE systems have the ability to flag off any prescriptions or orders that seem to be quite extreme thus eliminating chances of wrong prescriptions. To illustrate, a report by Bates et al. points out that the CPOE systems were able to reduce unnecessary medical errors by up to 55 percent since the system ensures that at least, the prescribed orders are legible and complete (2007).
This HIT system has therefore played a huge role in the improvement of the general quality of patient care. The above diagram adapted from the National Institutes of Health (NIH) website can be used to show how HER systems integrate patients data in different departments within a hospital. Despite the discussed benefits of HIT systems towards the improvement in the quality of patient care, a huge percentage of patients data and information still remains written on paper rather than on the electronic systems.
Fundamentally, this can be due to several factors such as high costs of the systems, complexity in operating the systems and the speculation that HIT can hamper patient care. It is thus important for the government and other key stakeholders to ensure that all health care facilities acquire these systems. For instance, the government can fund hospitals to acquire these systems or urge companies producing these systems to reduce the prices through acts such as providing tax reliefs to them. Furthermore, the nursing curriculum should incorporate an educative framework on how to use the system as well as inform the nurses on the importance of these systems towards the quality improvement of patient care.
Therefore, although there may be many debates on whether the use of HIT systems will improve the general health and quality of patient care, it is beyond doubt that the adoption of these systems by hospitals is a major step towards effective healthcare. In the past, these systems have proved themselves to be of importance more so when it comes to the general improvement of the patients health. For instance, during tragedies such as Hurricane Katrina and Haiti earthquake, patients records that were saved electronically using HIT systems were easily accessible, whereas those that were saved on paper were immensely destroyed.
It is therefore important that all health care facilities adopt the use of HIT systems in order to improve the overall quality of patient care.

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Qualitative and Quantitative Research college application essay help online: college application essay help online
You have been hired by a group of downtown merchants to help fight an increase in parking costs and fines for violations. The municipal government insists that it must increase revenues in order to maintain sidewalks and streets, cover law enforcement costs, and collect fines from repeat violators. The merchants are concerned that an increase in parking costs will drive away customers who will simply take their shopping to malls or other shopping areas where parking is free.

Discuss:
In a Discussion post, foroneof the above scenarios, address each of the following:

Describe at least one qualitative research step and one quantitative research step you should take before you begin.
Describe your internal audiences, breaking them down into as many subgroups as necessary.
Describe your external audiences, breaking them down into as many subgroups as necessary.

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Our essay writers are graduates with bachelor’s, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
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Personal Code of Ethics for Health Care Professional extended essay help biologyThe paper Personal Code of Ethics for Health Care Professional” is an inspiring example of a personal statement on health sciences & medicine. The author suggests that in performing his duties as a healthcare profession, he must: – Act in the patient best interest. – Conduct professional activities with honesty, fairness and good faith in a manner that will reflect well upon the profession. – I will follow laws and regulations pertaining to healthcare management that are located. – Avoid exploitation of the patient for my personal gain.
– Ensure that there is a proper way of evaluating the quality of service offered. – Avoid practicing discrimination in the organization. – Ensure there is a process that gives advice to patients about the risks associated with certain healthcare services. – Ensure there is a process to resolve conflict in case it arises especially between patients and the employees. – Ensure there is no abuse of power that could affect patients served and how to deal with it if found. – Ensure that the patient information kept confidential all the time.
– Provide quality healthcare service using the available resources and if resources are limited find a way to get the resources. – Respect the customs and practice of patients according to the organizational regulation. – Provide a safe and healthy working environment for employees working there. – Provide resources for staff to address ethical organizational issues. – Give patient adequate and accurate information in order to make the right decisions. – Maintain the safety of the patient ahead of everything.
– Maintain professional integrity. Discussion Personal belief has no places in a health care workers life since one has to act in the patient best interest because it is their duty to serve them. For instance, is a patient suffering from liver cirrhosis the doctor has to treat him because its the patient best interest he wont refuse on the basis that its a sin to drink alcohol? The patients information should be kept private since these records belong to the patients although the them.
Ethical and legal rules govern These documents. This privacy helps the patient to be free with the health care provider knowing that the information is confidential. who receive confidential information in their professional capacity are supposed to legally and ethically to protect it against any disclosure (Stanford & Connor, 2014). Perform a duty by being honest and fair to the patient. It will help the patient know the real condition that they are inland also by giving the patient the best advice, not the advice that benefits you as a healthcare provider.
Following laws and regulations pertaining to healthcare management that are located. This will help health care workers avoid having problems with the law. And will also help the image of the facility. A healthcare executive should make sure that the procedures for evaluating the quality of service are properly put in place. It will ensure that the provides services that are up to the required standards. The responsibility of health management is to evaluate the quality of services they provide.
The management should ensure that there is no discrimination in the health care facility. All employees should be equally treated and in case of a problem, the one responsible should be a question. Healthcare providers are supposed to ensure that adequate information is given to the patient about any medical procedure he/she is to undergo. He should give out the information including the advantages and disadvantages of certain procedures, this will help the patient to make the right decisions.
Health care providers should ensure that they have put in place adequate rules and procedures to handle conflict when they arise. Especially if it is between employees and patients, this will help build the reputation of the health care facility. The executives of healthcare facilities should ensure that there is no abuse of power since this could affect the quality of services patients could receive. They should also find the solution to if a case is found out (Stanford & Connor, 2014).
Such regards render the services being offered to loose meaning, it robs away the trust built by the management concerning the customer base and hence should be safeguarded. Conclusion Healthcare employers should provide a safe and healthy working environment for themselves and their patients. This will help the patient have positive thinking about health care and will build their confidence in the facility. The should give their employees a chance to address the unethical issues and resources to use in addressing them.
They should have the freedom to express their opinions. This help the employees feel they are part of the organization.

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While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.
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Statistics
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Regulation in Pharmaceutical Drug Counterfeit Market college application essay help: college application essay helpThe paper Regulation in Pharmaceutical Drug Counterfeit Market” is a breathtaking example of a research proposal on health sciences & medicine. In the identification of purpose, I summarized the main idea of the essay by emphasizing on the current and effectiveness of contemporary regulation in the pharmaceutical drug counterfeit market. In this perspective, I determined the social environment as the main factor of its either success or failure. For this aim, the presented paper mostly analyses available literature on the topic.
In this context, I used both the library and online articles (using Google Scholar engine) from different years to understand the dynamics of changes in the context of writing. At the same time, I used only the most contemporary ones among them in the research (starting from 2006 and ending 2014). While reading the sources, I divided the ideas from them into three groups. In the first part, I needed to determine the sphere of analysis both concerning the problematic field of and providing main definitions for its investigation.
Furthermore, I concentrated on the discussion of the need for regulation itself and the potential for the public rule of this process without contemporary institutions. Finally, the last part raises the question of how the current efforts of both international and domestic actors in USA and EU cope with the current problems in the . On the way of searching for the information in the books, I read the full content of the journal articles to understand both the general idea and the case studies they analyze and the selected chapters from the required book (Baldwin et al., 2012). In the conceptualization part, I started by determining the main social obstacles to the effectiveness of counterfeit regulation.
In this context, circumstances of the global economy make it hard to guarantee an equal set of regulation rules for both developed North and developing South. Moreover, the contradiction between economic profits and social responsibility inevitably appears in the case of pharmaceutical counterfeit regulation; hence, I conclude that it is a political battle in the framework of interest groups theories. By providing key definitions, scholars demonstrated to have no united vision on the counterfeit drug term, in contrast to other medical definitions (like pharmaceuticals).
Although, most of them agree on that counterfeit drug includes criminality as an essential element of its production; thus, the term itself is rather political than scientific. In general, a literature review has shown that there exist severe theoretical difficulties to the effective regulation in the pharmaceutical sphere. After discovering severe problems in counterfeit drug regulation and conceptualization, I discussed the very need for this policy for the two interested groups: business and public sector.
On the one hand, companies had already taken some defensive measures in order to face the problem with counterfeits. Nevertheless, invisible hand of the market is incapable to regulate such a sensitive sphere as health since only the spread of the diseases can increase the profits of pharmaceutical companies. On another hand, the current appearance of the pharmaceutical industry makes it hard for people to judge the drugs they take by themselves. In support of this statement, high costs of laboratory checking, invisible problems in the supply chain, and the fact that poor people prefer cheapness to quality prove that there is a need to in combating counterfeit drug market.
In short, the revealed information in this part raises the question of regulation effectiveness, as the appearance of this problem is serious and crucial for both business and society. In the last part, I concentrated on the current appearance of counterfeit drug regulation in the global context. In this case, literature reflected the discussions around regulatory instrument of intellectual rights, challenging the influence of international e-commerce, and ineffectiveness of WHO in case of counterfeits.
As the British example showed, the established MHRA demonstrated its inability to regulate the domestic market with such severe problems in the international environment. Concerning counterfeit drug regulations effectiveness, contemporary international institutions cannot solve the existing division in economic interests and political will between developed and developing countries. Thus, they need to on the highest level and guarantee transparency for all the involved actors in order to increase the effectiveness and mutual trust in the counterfeit drug market regulation.
As a result of the presented research, it turns evident that even though counterfeit drug regulation is crucial for both society and business, it is not effective enough to deal with the problem internationally nowadays. In fact, the difficulties with it appear due to the political nature of regulation in the sphere and the inability to determine the criteria of the counterfeit drugs in a scientific manner. Thus, the positive feedback on the current state of regulation refers to the profitable actors from the developed countries only.
However, the importance of regulation is also evident for both the developing countries and the public that is suffering from health problems. In this context, the emphasis on the interests of developed countries indicates that regulatory institutions recognize economic interests above social consequences of the presented problem. Hence, the increase of public awareness is crucial for the improvements in counterfeit drug regulation.

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Becoming a Public Health Practitioner Discussion write my essay helpThe paper Becoming a ” is an exciting example of a personal statement on health sciences & medicine. From a tender age, I harbored a strong interest in participating in the eradication of low levels of access to health care in my home country, Ghana and the eradication of preventable deaths, as a . I believe that studying public health will be beneficial in achieving this by providing the requisite skills and knowledge for success in the work environment.
Despite the financial difficulty and other challenges that I have had to overcome including working as a security guard for five years, my passion for helping others and augmenting the health and sanitation levels in the community has never decreased. With each passing day, I believe I am getting closer to this goal and this personal statement depicts my determination, strong will, commitment, and passion to succeed and I hope that it will serve to show my strong desire of working as public health officer opening the way for access to study public health at your university.
There are several reasons for my desire to enter the public health field including a passion to help others, strong interest in sciences with biology being my favorite, and access to an opportunity to give back to the community. For five years, I have worked in a security guard position that has enabled me to learn to be attentive to peoples needs, manage time efficiently, develop excellent organizational skills, and interpersonal skills that will prove effective in the public health field.
Dedication to duty and withstanding long hours of work and the need to pay attention to details are the others personal skills that I have developed over the years that I believe will be paramount in achieving the best I can as a public health practitioner. Currently, I am studying Access to a nursing program at Barking and Dagenham College which I will be completing in June 2015. This will form the other basis for my success in the public health study.Working under no supervision, following instructions accurately, proper records development, and clear communication are some of my individual characteristics that will prove beneficial for me to succeed in the medical field.
My dedication and concentration are depicted in the attached resume showing my abilities in terms of academic performance and ability to concentrate to achieve better. I plan to work hard and dedicate myself towards the achievement of the goal of becoming a public health practitioner. I believe excellent performance and attention to minute details both during studies and in the work environment are important for the success of a public health worker and it is my aim to achieve this to better my chances of serving the public and the community at large.
My , cooking, walking, and meeting new friends and will allow me to cope with the high demands that come with courses within the medical field but with my determination and passion, I believe I will be successful. My preparation in the preceding years has been adequate both emotionally and academically, and I believe I am in a good position to take the next step in achieving my goals in life through public health study.The attention to detail, effective communication, well laid out plans, and access to all the required information are some of the main reasons for choosing your university to pursue public health.
I believe with the facilities, human resources, and at your university, I will have adequate training and skills to propel me to greater heights in the public health field. Access to both practice and theory in a creative and balanced manner will be very effective in meeting my needs for success and will form the main basis for success in the work environment further providing reasons for choosing the University. At the university, I believe I will have access to numerous opportunities for personal and professional growth and development through interaction with students, faculty members, and other health professionals allowing me to have a wide range of mentors and advisers throughout my learning years from whom I can access invaluable knowledge and skills.
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Finance
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Computer science
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Psychology
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Engineering
Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.
Nursing
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Sociology
Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.
Business
We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!
Statistics
We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.
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