Medicaid in Oregon State

Medicaid is a governmental health care program that provides coverage to millions of low-income individuals. The program has a significant impact on adults, pregnant women, children, disabled persons and seniors under specific qualifications (DHS, 2006). The Oregon Health Plan also covers women who have symptoms of breast and cervical cancer. The program has a significant impact in Oregon in that since the implementation of the coverage; it has brought improvement in the following areas. First, Medicaid coverage has reduced depression in that the total number of people who suffered from depression before the Medicaid access was 30% but the number has reduced by 9% since the implementation of the program (DHS, 2006). Medicaid coverage has also improved the health care access in that as people feel unwell, they visit the doctor and receives prescription drugs, and they also have better access to mammograms, PSA test and more. The vital area where the coverage has a significant impact is the reduction of financial strain. People who have the coverage reduced catastrophic expenditures on health care thereby reducing financial stress. The coverage has a significant impact on the diagnosis of diabetes and patients who have diagnosed receive medications and can control the condition. The program will continue to offer unmeasurable benefits since the State has solved the financial challenges by introducing a new health insurance plans based on raising the tax to bring additional revenue. In 2016, the total number of people who were enrolled was 460, 605 and the number will increase by 400, 000 by 2022 (DHS, 2006). Overall, Medicaid in Oregon has reduced medical debt, increased access to care and improved financial security.

Reference

 Department of Human Services (DHS). (2006). Oregon Health Plan: An historical overview.  Retrieved

from: http://www.acupunctureresearch.org/assets/docs/C2017/Oregon%20Health%20Plan%20-%20An%20historical%20overview.dhs.2006.pdf

Medicaid and Medicare in Florida State

Medicaid is a national health care program that provides coverage to millions of low-income individuals in Florida since January 1970.  Medicaid program is funded by the state and the federal government to offer health care services to people adults and children who lack insurance coverage. The program has a significant impact on low-income adults, pregnant women, low-income children, disabled persons, non-citizens and seniors under specific qualifications set by the Florida Agency Health Care Administration (DHHS, 2009). On the other hand, Medicare in Florida is a health insurance that covers senior citizens aged 65, disabled individuals and people with kidney failure.  However, Medicare program does not have a significant impact since it involves fee-for-services coverage and out-of-pocket expense. There are also premiums that increase over time and contain strict coverage rules such as ‘not to seek care to a different place’.

The Medicaid program has a significant impact in Florida in that since the implementation of the coverage; it has brought improvement in the following areas. First, 17  million women of reproductive age are covered by the  Medicaid, and they receive a comprehensive health care services such as family planning,  maternity care, ultrasound,  mental health care, surgeries,  breast and cervical cancer and more (DHHS, 2009).  Second, the Medicaid program has a significant impact as it provides the Managed Medical Assistance- this involves dental care and behavioral health services.  Medicaid also provides the Long-term Care- this involves the community-based care to disabled and senior people.  About 85% of the enrollees receive Managed Assistance care.  The two program coordinates to provide comprehensive care to the eligible people (DHHS, 2009).  Third, Medicaid program in Florida offers an extensive patient base especially to a low-income population where they receive community behavioral health, home health care, and prescription medications.

In 2016 the total number of people who were enrolled was more than 3.6 million. The number will increase since 68% of residents are for to Medicaid program to cover the 467, 000 people who are in the coverage gap (DHHS, 2009).  The state should implement a quality strategy to improve the Medicaid performance level.

Reference

Department of Health and Human Services (DHHS). (2009). Medicaid Integrity Program: Florida Comprehensive Program Integrity Review. Retrieved from: https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/FraudAbuseforProfs/Downloads/FLfy09.pdf

    Diversity

Introduction

Pharmacy profession requires a person to show commitment in promoting diversity by valuing equality and being inclusive in the various places including work, learning institution and authorities. My commitment to diversity is based on adoption of policies and behavior that will encourage inclusion at different levels.

Discussion

My commitment to diversity in the pharmacy profession is based on using regulatory provisions and roles to facilitate integration and working towards the promotion of desired behaviors. The integration process will focus on individuals, organization and the public. By knowing the goals of diversity in pharmacy profession and how it connects to the entire public and organizational goals, the commitment to the process will be easy to cultivate.  The commitment will be inculcated through encouraging quality opportunity for everybody in the education system and employment field.  The approach involves making sure that unlawful discrimination is not arising in employment or against other members of the public, authorities or even the users of the services offered in the profession. The best way to ensure that diversity is upheld is through advocating for the adoption of policies that safeguards the rights of all people regardless of differences in gender, race or ethnicity are observed. The policy should touch on all levels of authority in organizations, since leaders are best placed to ensure its implementation.  The will act as a safeguard against any actions that may be considered illegal discrimination acts and will show a commitment for equality in the profession. 

I also intend to  promote a culture that is inclusive for  all the individuals that I will come into contact with during my practice , especially the people I work with and those that I will be serving in my profession.  This involves following the regulations and policies that have been adopted to facilitate commitment to diversity. Through behavioral change, the services will not only accessible to the entire population but will be appropriate for everyone.  In any leadership position that I may hold, I will work towards provision of organizational capability for constant learning, improvement and even sharing good practice to all people at various situations. As a leader, I will strive to ensure that various behaviors in a team or organization that may encourage harassment or discrimination are eliminated. Through the various decisions made, communications and activities, I can positively promote equality among other people upon which I have an influence in the profession. Upholding dignity in a working environment can ensure issues such as targeting an individual on any ground is not tolerated.

 Having an environment through which complaints can be raised will go a long way in ensuring that diversity is respected. Learning is an important aspect in promoting such an environment and using best practice as a basis of learning, especially by engaging with organizational members, local networks and even community and their feedback will ensure diversity commitment is realized. This is true if it happens on a regular basis.  I will ensure that the equality policies or action plans are linked directly with the planning strategies of an organization, while focusing on integrating Diversity and Inclusion into the all the functions or operations. By facilitating the collection of data from the various stakeholders, it will be possible to analyze where diversity is not being promoted, analyzing impacts of organization and changing the policies or even services where necessary.  Also, it will be important to consider individuals who are vulnerable to discrimination or harassment due to their background and especially while seeking health care. By ensuring that the individuals are safeguarded against people who may exclude them, diversity is upheld.

Conclusion

Adoption of appropriate policies will ensure that cases of inequality, discrimination and harassment on whatever grounds are dealt with. Encouraging a culture of inclusivity is an indicator for a commitment to diversity in different situations.

Admission essay

 Nursing Scholarship

            Nursing is not only a career choice, but it is also a calling.  I developed a deep desire of serving people and promoting the well-being since I was young.  I have an empathetic heart of helping people physically, emotionally and socially when they are in vulnerable moments.   I desired to join a nursing school and become a registered nurse to help the community through performing diagnostic tests, providing treatment and educating patients on disease prevention and management.  However, after I graduate RN school, I desire to further my education and become a nurse practitioner.  I want to make a difference in my community, and I would like to subspecialize in some areas such as women's health and aging populations.  I want to meet the unique needs of both young and old women.  My goal is to ensure that the patients receive high-quality healthcare and more importantly, reduce hospital readmissions and hospitalization.  I also desire to focus on analyzing the risk factors, offer individualized treatment plans and provide evidenced-based education on prevention and management.  As a nurse practitioner, I will not only provide high-quality health care, but I will also act as a counselor and researcher.

 The Kasey Marshall Nursing Scholarship will reduce my financial burden and assist in furthering my education, gaining the experience and pursuing my goals. It is important to say that I recognize my potential in my academic career and the scholarship will assist in fostering growth since I will specialize in the area of interest. The scholarship will strengthen my opportunity to increase knowledge and skills by dedicating my time to study.  By winning this scholarship, I will attain my goals and receive an excellent education.

 My skills and personality traits such as self-confident, calm, empathy, compassion, communication skills, problem-solving skills, detailed oriented and emotionally stable will help in meeting the community needs and promoting the well-being as a nurse practitioner.

 Question 66: May a physician refer patients who desire morally excluded services?

1. Case Summary

An obstetrician-gynecologist who practices Catholicism has a moral dilemma, due to making a commitment to conduct his medical practices according to the teaching of the Catholic Church. The physician is indecisive about whether it’s ethically acceptable to refer their patients who ask for an abortion, sterilization or contraception to doctors who most certainly will help them to satisfy their will

In this case we read a story from a person who works as a gynecologist and is a faithful Catholic. Their concern is a moral dilemma. The questionnaire cannot decide whether it is fine for them, as for a Catholic, as a religious person, the questioner finds those actions immoral and does not want to be sinful of taking part in them. They want to practice medicine in a strict agreement with the Church’s order.   Therefore, they ask Grisez to resolve their problem. 
    As Grisez puts it, referring a patient to another specialist who most certainly will provide them with services Church calls immoral is a problematic thing to do. It weakens physician’s position and makes them vulnerable to be suspected in lack of principles which they base their practice on: “Since physicians making referrals ordinarily intend that the patient receive the service for which he or she is referred, a patient so referred and others hearing about it would reasonably think: “This physician does not wish to dirty his/her own hands with things like abortion but does not mind having others do them.” (Grisez, 2004). As a Christian, Grisez, of course, believe in God and absolute morality. Therefore, the possibility of performing something like prescribing contraception, sterilization or abortion is not taken into consideration at all (although, Grisez justifies abortion in certain cases, when they are necessary to save parent’s life: “On this assumption, the proposal adopted is, not to kill the unborn baby, but to have him or her removed from the womb, with death as a foreseen and accepted side effect. An abortion carrying out such a choice would not be an intentional killing.”(Grisez, 1997). They are wrong and taking part in them is also wrong. Consequently, Grisez suggests the questionnaire to warn their patients about their beliefs at the beginning of cooperation and to act accordingly, giving the patient the possibility to decide whether they want to receive treatment from a Catholic gynecologist right away. He also writes that gynecologist have to do their best to save the child anyway and they ought to try to convince the patient not to get the immoral procedures but warn them about difficulties of their condition anyway: “You may advise the patient not to neglect her problem and/or warn her against some inappropriate action, for example: “You must not let this go, so you should see someone else as soon as possible” or “Don’t march off to the neighborhood abortion clinic, for they will simply do an abortion, while ignoring other aspects of your problem.”
    According to Philippa Foot’s philosophy, there must be some objective grounds to the moral principles. Although she explains morality as a system of hypothetical, not categorical, imperatives (Foot, 1972), she claims that moral judgments need a reason for them. Foot argues that morality should be rational despite one’s personal feelings about it. If one can’t provide their morality with rational and objective argumentation, they are being immoral and what she calls “defective”. “One shouldn’t think that morality must pass the test of rationality, but rather that rationality must pass the test of morality” (Foot, 2003) says Foot, which means she stands for a system of a practical rationality that would go through facings of morality: “One shouldn’t think that morality must pass the test of rationality, but rather that rationality must pass the test of morality”(Foot, 2003). She is strictly anti-relativistic and argues that person can be defective despite what their interests are, which means that they are responsible for the harm caused by their actions even though they may not personally believe that they ca are using any harm. “Nevertheless, he is defective. For he is failing to recognize and act on something that is a reason.” The reason must arise from natural goodness: “ I argue that thinking in terms of natural goodness, as I define it, provides this unity. Both the taking of means to ends in an efficient way and the recognition of relevant reasons are things needed in human life, and a defect in either of these is a defect in practical rationality”(Foot, 2003). I would suggest that Philippa Foot would disagree with Grisez in his answer. She would say that physician’s role is to save the patient and they don’t have to address their personal beliefs to do so. They should do what is better for the patient and what is the most rational choice in a given situation. They should do the good thing, and the good thing is not what makes them happy, Foot would say, but what is beneficial to a patient. 
    Even though Grisez has nearly convincing suggestion for the questionnaire to merely warn their patients about their faith and practice, which seems plausible, I would agree on this with Foot. Medicine is a field where specialists are very often faced with difficult moral decisions. Therefore, they sometimes may need to decide very quickly what to do. In the given case there is no warranty that the physician would not lose their clear judgment underestimate the severity of the patient’s condition in order to adhere to their morals. And their refusal to work with a patient may postpone the receiving the necessary help.  Overall, if one knows that their practice can happen to contradict their creeds, they should not start it at all. 

1

Regarding the case, Grisez would disagree with Philippa Foot. For instance, Grisez advice a doctor not to refer a patient to medics, knowing well enough that him or her is going to get a treatment that does not abide with their principles. Instead, the doctor should ensure that wherever a patient goes, he or she receives medication that corresponds with their moral standing. (Grisez, 1997). On the other hand, and in a similar situation, Philippa Foot would take a different stand. She claims that due to philosophical contrasts, the doctor should do according to the will of the patient regardless of morality. Philippa Foot brushes aside morality as only a reaction and with no foundational basis at all. This means that if the tables turned, and the patient became the doctor, he would apply different moral rules due to the change in context. There are no specific morals standards applicable to all the people at once. Foot tries emphasizing that morality is just a feeling that differs from one society to the next or from one person to another. Whether it is right or wrong to engage in something entirely depends on the commitment of a particular individual to that feeling or line of thought. Therefore, a doctor does not go against the teaching of their values or moral obligation when they meet a patient who does not subscribe to their system of thought or values. Morality should not exhibit any form of subjection. The moment it does; it becomes bias (Grisez, 1997).

2

Foot takes a flexible point of view. She gives alternatives and sentiments that simplify the work of a doctor. The field of medicine relies heavily on genuine work (Foot, 2003). Facts do not undermine morality and other values but give a precise solution to the predicament. For example, in a state of affairs where a patient requires sterilization, the work of a doctor is to look at all the aspects that can make the procedure successful for the patient. Rather than deny her the chance based on morality. Lack of a hardline in her opinion gives everyone a chance and responsibility to bear the burden of his or her choices. A doctor has one call, and that is to ensure medication of his or her patient.

Foot makes a vital point. The type of perspective one takes in every situation makes the difference. A doctor can ask a patient the reason behind their choices. Some of the underlying causes may give a chance to correct the patient or get to see their situation from their perspective and empathize with them. Morality presents a one-sided part of the case and does not show the side of the patient who might have a valid reason for undergoing a particular procedure. Any moral choice should coincide with evidence to support and cement the moral judgment and give it the credit it deserves to shape opinion and stand legitimacy. One should not just say an act is wrong. They should provide enough evidence to show that it is indeed wrong. In this manner, all points of view intermarry and agree on the way forward as opposed to following a person's beliefs and code of conduct. The underlying point of Philippa Foot gives a different angle that at the same time retains values and ethical god will cater to the needs of humanity (Foot, 2003).

References

Foot, P. (1972). Morality as a System of Hypothetical Imperatives. The Philosophical Review, 81(3), 305–316.

Foot, P. (2003). The Grammar of Goodness. Harvard Review of Philosophy, 11, 32–44.

Grisez, Germain Gabriel. (1997). The way of the Lord Jesus (1st ed.).

Grisez, R. H. F. P. of C. E. G. J. (2004). Difficult Moral Q

References

Foot, P. (1972). Morality as a System of Hypothetical Imperatives. The Philosophical Review, 81(3), 305–316.

Foot, P. (2003). The Grammar of Goodness. Harvard Review of Philosophy, 11, 32–44.

Grisez, Germain Gabriel. (1997). The way of the Lord Jesus (1st ed.).

Grisez, R. H. F. P. of C. E. G. J. (2004). Difficult Moral Questions (1st ed.).

Browning, H. & Van Velsor, E. (2000). Why seek assessment, challenge, and support? In Three

            Keys to Development: Defining & Meeting Your Leadership Challenges (7-9).

Buckingham, M. (2007). Build strong habits: Put your strengths to work. Leadership Excellence,

            Vol. 24.

Conger, J.A. & Fulmer, R.M. (2003). Developing your leadership pipeline. Harvard Business

            Review,  76-84.

Ibarra, H. (2002). How to stay stuck in the wrong career. Harvard Business Review, 40-47.

It is very true that we are born with different configurations and are not the same in terms ability, strengths, and weakness among other attributes. It is in this light that I agree with Buckingham (2007) that we see ourselves as different from others and continue to work on our strengths and thereby building on strong habits. To preserve on our strengths path, one has to build the right habits, so that the individual maintain control, continuously striving toward actions that strengthen a person, always watching for those that let us lose our focus (Buckingham, 2007).

In order to maintain our focus in building strong habits, Buckingham (2007) maintains that each day we list three strong statements and three weaknesses in our own words and make a commitment on how to deal with them, spending about 15 minutes of our time completing a robust week plan where one’s takes a hard look at what they have done in real terms to work on their strengths.  Another action plan is having a discussion with one’s supervisor concerning how they are managing their strengths for possible feedback and this should happen once every quarter (Buckingham, 2007).  I must admit that that these action steps are solid in trying to build strong and vibrant habits, but there has to be a strong commitment on one’s part to really deal with their own pathway to building good habits.

Developing your leadership pipeline – Jay A. Conger and Robert M. Fulmer

Leadership is a key to the success of every business and so, good organizations have to invest in those who they consider have the abilities to lead others. In this sense, very elaborate strategy should be devoted to mentoring, developing people to become good leaders for their respective institutions. Conger and Fulmer (2003) intimate five core principles that should be followed when engaging in succession planning. Firstly, there must be flexibility where the system leans toward developmental activities and not an unyielding list of high-potential personnel and the openings they might fill in succession planning.

The second rule is that planners should not forget about middle level management where they group of leaders could be. Generally, succession planning has become the exclusivity of very few executives of an organization whereas succession planning generally should trickle down to mid-level management since they form part of the long-term strategy of the health of the institution (Conger & Fulmer, 2003). Breaking up the two functions- senior executives and mid-level management into a single system enables organizations to take a long term view of the process of organizing middle managers, even those below the director grade, to aspire to be general managers (Conger & Fulmer, 2003).  Thirdly, there should be transparency in the process since it is for the betterment of the organization. This point drives home very clear because in all the organizations that I have worked, the process has been shrouded in total secrecy and no one really had a hint except a few lucky  who are powerfully connected to the upper echelons of the executives.

The measurement of succession planning process on a regular basis is the fourth rule. Many a time, Human Resources personnel identify key people to groom and  there is no formalized plan to bring them up, and as a result,  there is no way of regularly measuring progress or checking in to see whether people have feedback. Executives usually wait until there is crisis before they even remember that they should be working on a plan. The last rule of thumb postulated by Conger and Fulmer (2003) is that succession planning should be flexible. My manager always maintains that complicated plans take long to materialize and sometimes waste everyone’s time; but an easy-going and flexible plan usually gets people’s attention and moves fast. According to Conger and Fulmer (2003), classical succession planning is fairly rigid; people do not progress on and off the list lithely. This should not be so because it must help people to succeed.

How to stay stuck in the wrong career – Hermina Ibarra

Getting stuck in a certain job type can be very unsettling depending on what one is looking for in a career or depending on one’s educational level or commercial acumen. It is based on this that doing something one enjoys becomes necessary since there are passion and commitment involved.  Scholars have found out that humans fear change and are not likely to change quickly, and so they stay in a career regardless of what type of job they are doing (Ibarra, 2002). The conventional wisdom has been to know what we as humans want to do and letting those acquired knowledge guide our activities but Ibarra, (2002) thinks otherwise – doing what we want to do should come first and knowing what we want to do comes next.

 Ibarra, (2002) suggests that it is critical for us humans to really know ourselves and what we want before contemplating a career change. Knowing oneself comes out of a deeper reflection or self-introspection or standard questionnaire. This is one of the hardest exercises to complete since it is not very easy to do that self-analysis. After the self-introspection or self-analysis, there are abound to be questions and some things that may not be clear and Ibarra, (2002) suggests to seek advisers who you can share ideas with in the course of changing careers.

These advisers should be people you hold in high esteem and those you can trust to give you solid opinions to make you better, and not worse. One should not rely on people they are comfortable with since they will tell them things they want to hear, rather those who can give honest and objective feedback.

Career changes can be a daunting exercise and could make or break one’s life if not carefully vetted, and that is why we will need to think big during these times of change. In thinking big, Ibarra, (2002) suggests that we should do this in a more careful and gradual manner so as not to defeat the purpose since big things could crumple on the individual making the change. Our identity should at some point come to play in the process. We need to think about the future of the organization we are seeking to join and most importantly, our impact or future plans with the move that we want to make.

Why seek assessment, challenge, and support? Three Keys to Development: Defining & Meeting Your Leadership Challenges Henry Browning & Ellen Van Velsor

Leadership development has to be all about building capacity and has to be over a period of time making it imperative to seek support while taking series of assessments to evaluate one. For a lot of individuals, the capability for leadership must be unceasingly established over a lifetime of experience (Browning & Van Velsor, 2000). Even though individuals who have or expect to have leadership duties normally attend leadership development programs to attain the needed talents and perspectives, most leadership development occurs outside the normal classroom on job assignments, through connections with others, or from services to the community or other experiences outside of work arena (Browning & Van Velsor, 2000).

I recently attended a program at the Center of Creative Leadership and can confidently say that it really helps students learn a lot about themselves through the 360 degree feedback assessment. Benchmarks for executives are a statistically dependable, effective, and comprehensive 360-degree feedback instrument. Also, in offering feedback to assist identifying strengths and development needs, it ensures what its name proposes by providing the students with a benchmark of how they are doing when compared to a meaningful norm group (Browning & Van Velsor, 2000). Benchmarks for the students/executives are focused on the Center for Creative Leadership's (CCL) studies of how effective executives develop.

Recreational marijuana

Introduction

The legalization of marijuana has a lot of benefits that outweighs the disadvantages. A recreational drug can be defined as utilization of a drug or substance without the permit of a medical expert due to the effects. Most people use recreational drugs due to the sole purpose that they do not contain highly addictive substances. Some of the pros of using recreational drugs, in this context, marijuana stated below.

Pros

Most people support the legalization of Marijuana due to its usefulness in the medical sector. An estimated 84% people claim that the drug has positive medical utilization. Thus, the government should consider legalizing it. To back the claim a medical research proved that smoking pot has medicinal advantages to the smoker (Fisk, Vonasek, & Davis, 2018).

A part from its medical use, statistics shows more than half a million Americans used the drug in spite of the illegality due to federal laws. As result, legalizing it would add to the government revenue through taxation. Taxation will come with legal jobs and income to the peddlers of the drug. Thus, in the long run, it would boost the macroeconomic of the community. This a win-win siutaion between the government and the abusers (Fisk, Vonasek, & Davis, 2018).

Cons

 Opponents of the legalization of marijuana w base their argument on regulation. Legalizing the drug would lead to irresponsible especially among the teen and youths. In addition, they further claim that funds retrieved from legalizing the drug will not overshadow the medical expenses incurred during hospital visits caused by the recreational marijuana. Other effects such as addiction and increase in violent crime together with negative effects caused to the surroundings are some of the major concerns to the opponents. One of the most airtight argument by opponents of legalization of marijuana is that even if the use is medical, the effects remain the same and medical reasons do not shield any patient from exposure to short and long term effects of the drug (Fisk, Vonasek, & Davis, 2018).

Court case that led to the legalization of recreational marijuana

In 2016, the Supreme Court rejected the cases submitted before it by Nebraska and Oklahoma. The cases by the two states were against Colorado. Colorado carried out a referendum. In the referendum, legalization of marijuana became a reality. This occurred in 2012 (Harpin , Brooks-Russel, Ming ,James,& Levisnson,2018).

The Supreme Court threw out the cases brought to it by the two states. The two states suggested that legalization of recreational marijuana by the neighbor state; Colorado would affect their states, as people would sneak it through their borders. Some conservative judges claimed that the court would give chance to the file against Colorado .Nevertheless; the states that had brought forth the case claimed that recreational marijuana has adverse health effects to the user. Safeguarding children at school or any other institution would challenge the state officials. The two sates claimed that Colorado has set a dangerous precedent and that it should proceed with caution not to interfere with the peace of other states and take necessary measures to safeguard its residents against the negative effects of the drug (Harpin, Brooks-Russel, Ming, James, & Levisnson, 2018).

Colorado claimed that it followed due procedure to implement the new law that saw legalization of recreation marijuana. In addition, it took note of the current administration of the time. The Obama management claimed that it lacked proper resources to ban marijuana. Hence, the only option was finding a legal way to legalize it. The   two states still held their position on the case and claimed that the legalized recreational marijuana in the neighboring Colorado continued to cross their borders. This was against the federal laws of the states. Colorado counter claimed the accusation and claimed that the suit was filed on inventive jurisdictions, which deals with cases that avoided low courts. Therefore, the cases filed by the two states needed an open approach and better leadership from the two states rather than rushing to court in protestant with an aim of limiting the rights of another state (Harpin, Brooks-Russel, Ming, James, & Levisnson, 2018).

Statistics on states that legalized recreational marijuana

In the United States of America, nine states have already legalized recreational marijuana. One of the states in Washington D.C. As long as one is, 21 years old and above, theycan2 enjoy the drug with any worry   of arrest. Medical marijuana is legal in 29 states. Support of the legalization for the drug reached an all-time high in the year 2017.A poll revealed that 64% favor the legalization of the drug. The industry since legalization posted an estimated 10 billion dollars. Just to mention a few states. Alaska, Colorado, and California made the drug legal for their residents (Newton, 2013).

Legalizing marijuana went against the norms of the society. As a consequence, the notion of legalizing the drug did not utter well with the public. Moreover, one never knows it would turn out to be the next alcohol and cause for addiction in young adults. The thought scared a lot of people. Even after the public embraced the notion of legalization, it took time for people to get operating license (Newton, 2013).

Conclusion

The legalization of recreational marijuana pegs more on perception that the actual passage of law. Even though law may permit, the use of recreational marijuana    cons and pros can always depend on the point of view applied by the user. Therefore, the last decision lies with the user of the drug. It is up to them to interpret the effects and decide which side outweighs the other.

References

Fisk, J.M., Vonasek, J.A., & Davis, E. (2018).’ Pot’ Reneural Politics; The Budgetary Highs and Lows of Recreational Marijuana Policy Innovation Politics & Policy 46(2), 189-208 doi:10.11 11/polp 12246.

Harpin S.B., Brooks-Russel,A.,Ming ,M.,James,K.A.,& Levisnson,A.H,(2018).Adolsecents Marijuana Use and Perceived Ease of Access Before and After Recreational marijuana Implementationa in Colorado Substance use & Misuse ,53(3),451-456.doi:10.1080/10826084.2017.1334069.

Newton, D. E. (2013). Marijuana: A reference handbook. Santa Barbara, Calif: ABC-CLIO.

Interview summary

In today’s medical practice, practitioners are frequently involved in health policy. They look for opportunities to address issues where they may be well knowledgeable and well positioned so as to take appropriate actions.  The analytic nature of a policy brief allows the author to remain objective even when there is persuasive evidence. Public health writing is very important today because it relatively few have training in how to utilize their clinical experience and scientific knowledge to impact policy. After I interviewed the hospital dean, I found that developing a policy brief is one approach that health professionals may use to draw attention to important evidence that relates to policy.

The things she usually writes about is hospital department regulations, when we open a new department in the hospital, she said she needs to make a regulation that all the employees could follow the rules. I totally agree on this because from the health policy and theories class, I learned that it is also important because all the patients will see on the wall that they can keep the hospital works well. This involves institutional arrangement, evaluation of nurse and doctor and their summary report. Sometimes this includes the meeting planning, and some report article.

In my writing, I often focus on a particular issue where I explore it comprehensively. I do not just write about everything about the topic. However, having a rough draft allows me to choose the most important details about the problem. This allows for precision. In my writing, I ensure that I provide enough information for the readers to fully understand the issue in question and hence allowing the readers to come to a decision.

While writing, I often develop recommendations for the targeted audience. Readers are most interested in what I find rather than detailed information about how I acquired the information. Most of all my writing I will post on our hospital website. Or for the regulation will just put on the wall. So, all people can read it but most of them will be the person who seeks treatment. So, they will both go to the website and see it in hospital. All the nurses and doctor will read too because we will have a lot of article competition.

Being the dean comes along with numerous responsibilities that call for so much sacrifice. We are therefore limited by time to do some of the most important things such as writing. The workload is heavy hence resulting in minimal research activities and hence making it hard to write about an issue that has no enough data. The hardest part each time writing I feel is about when I am doing the institutional arrangements. Making rules is difficult because not all rules will fit the people who work at this hospital. I have to discuss with my employees first because I think this is the way they will more cooperate with me because if we made the rule together, it should be no excuse no mistakes in the future and easier for them to obey the rules.

At times, employees fail to perform effectively in their primary duties. They also fail to meet the responsibility expectations as professionals who have the experience either due to indiscipline or failing to meet job fit. It is due to this reason that they fail to meet the deadlines and are unable to attain their minimal goals. It is for this reason that I may decide to address the issue through writing where my target audience will be composed of health practitioners in the health setting. I write so as to make the communication with them about the policy changes and the new expectations that will ensure that all of these health professions meet all the expected outcomes and goals. Being a dean in the healthcare setting, I am responsible of writing a policy brief as this is the only way I can communicate health issues to health experts who are endeavoring to frame relevant policy data within a brief. This is important as it enhances a deeper review and understanding of the healthcare problems. As I write, I also aim at targeting policymakers who have the power or interest in influencing health policies.

Writing is very important to me because even though I am dean, I have to write them personally. Writing is not like talking, for writing, you will have a bunch of time that can summarize all the information, so you won’t forget the key point. Talking is easier because you just speak out what is just going through on your mind. When I trying to write something, I will organize them first, make an outline that I know what I m going to exactly write about. Then separate them like formula. Make each point more specific. Then have a little summary at the end of the paragraph. At the end of the paper, I will just combine all the key information together and repeat again in case me and my employee forgot. And each time after you finish writing, I feel easier to the organized and clear state than before on making the rules or plan. Through writing, I am able to meet my primary duties and responsibilities as a dean. This allows me to oversee the entire department and ensure effective teamwork and attainment of goals. I am also able to administer policies and plans for effective delivery of services. Writing is thus important for me as it allows for the development of strong communication skill that allows me to be competent in my administration of policies in all situations.

Writing brings about transformation. This in return creates an opportunity that guides and shapes the decision of general practitioners within the hospital setting. The decision-making process in the hospital setting is therefore based on the evidence provided in the policy brief. Translating health communication through the writing of policy brief for a policy focused audience ensures that our opinions are heard and that all members of the hospital remain engaged in shaping a brighter future.

 DaVita Dialysis Massive Medicare fraud

In the United States, Medicare Fraud cases have tremendeously increased. People are extracting money from the government through health care reimbursement which they are not entitled. In 2010, $47.9 billion was spent on Medicare “improper payment”. This directly affect the citizens who are forced to compensate the money through taxes. In 2007, a company DaVita Dialysis, was accused of Massive Medicare Fraud. DaVita is the one of the largest Kidney healthcare Company in the USA, owning 3’000 clinics. The company makes over 800,000,000 over bailing the government through medical fraud. These allegations were made by two of DaVita medical personnels, Daniel Barbir, former DaVita’s clinica director and Dr. Alon Vainer, a medical director, who saw the act as unethical. This essay anslyzes the crimes made by DaVita, why the government is the easy target for criminal, how medical personnel involved in frauds are always pardoned, and lastly, why their chances of detention are to small.

DaVita Dialysis committed a serious crime. It intentionally threw away valid medicines, for example, Venofer.  This allowed the company to increase the medicine sales and reap more profit from Medicaid and Medicare, governmental programs for the poor and the elderly respectively. The two programs are their principal. If a customer. If a patitient requires 100 grams of Venofer, the doctor would give 50grams and throw the remaining 50 grams on the trash, and later open up other Venofers which they billed the government. One of the accusers lawyer, Marlan Wilbanks, said. "It doesn't take a graduate degree to understand what's going on here.” "This is just dishonesty." The company’s Attorney, Kim Rivera denied the allegations saying even the government found the company innocent, and that the doctors actions were medically appropriate.

Over the years, frauds amin target is the government. The government owns huge amounts of money from tax payers which makes it hard to notivce and trace lost amounts. The US government does not notice the loss in the Medicare revenues, despite the huge amount billed by DaVita. Criminals reap huge amounts of money before they are caught, and when caught they can use that money to bail themselves out.

When caught, Corrupt medical personnel escapes the government’s punishment through corruption. They use the money reaped from the government to bribe the authorities. The medical executives pay the heavy fines imposed on them and businesses continue as usual. This leaves the poor citizens to continue suffering as the economy slowly deteriorates. Pat Burns, a Taxpayer Against Fraud, in the video says that 

Questions to Consider in Your Essay

1- Describe the crimes portrayed in the

videos.

2- Why is the government such an easy

criminal target?

3- How do corrupt medical personnel

elude capture?

4- Why is there such a small chance of

detection?

REFLECTION ON COUNSELLING COURSE

Abstract

Counseling concept has been experienced in the past and also in the modern ages, and it reflects an individual who seeks advice from another individual. To overcome behavioral problems such as depression and other related issues, individuals usually find help from family and friends or counselor.  However due to new technology, development of modern science and advancement in the field of psychology, theorists have discovered effective approaches, for psychoanalysis. The paper analyses the importance of counseling, the effectiveness and various methods of psychotherapy

Reflection on Counseling Course

            What I Have Learned

                Counseling concept has been experienced in the past and also in the modern ages, and it reflects an individual who seeks advice from another individual. Counseling involves advising or helping an individual to solve problems which might be issues related to family, school or even work. The life sometime may be challenging and even stressful, and when an individual is overwhelmed with the problems he or she can see a counseling professional in a private setting, and this process is referred to as counseling.

 Psychoanalytic therapy is a treatment which is based on the theories of Sigmund Fred, and it views that thought and behaviors are influenced by the unconscious mind. Its primary objective is to offer insight to an individual who is looking for therapy.  It tries to see whether individual childhood events have affected the lives of the client. It aims to make a change in personality and emotional development of the client (Hobson, 2016, p.2). Existential therapy is a philosophical approach that views that an individual is free to choose what he or she wants to do and to be responsible for the outcome.  This therapy is used to assist or help an individual to be aware of the meaning of life and the purpose (Carlson, Watts, & Maniacci, 2006, p25). Cognitive behavior therapy (CBT) first came into being between years 1980s-1990s as a result of convergence counseling approaches developed by Albert Ellis and Aaron Beck.  In this therapy, the therapist has much control of the techniques used in the process. Cognitive behavior therapy covers a wide variety of therapy types, and they are based on specific intervention used. These therapy types include multimodal therapy, cognitive analytic therapy and rational emotive behavior therapy (Persons, 2012, p.13).

            Carl Rogers who was American psychologist developed the person-centered approach in the 1940-1950s which also called client-centered or non –directive approach which is still now used today. In this approach heavy emphasis is directed on the client’s to be seen whether he or she can solve their problems. Rogers believed that clients could be able to develop and solve their problems using their resources and not necessarily seek help from the counselor.  Thus the role of the counselor in this approach is to help the victim be able to use his or her resources. For successful a therapeutic change, there should be psychological contact between the therapist and the client where both of them are on the same path of discovery and share common information.  The therapist’s responsibility is to advise the client on this journey since there are more experienced (Quinn, 2015, p.9).

    Unlike other forms of therapy that usually take time to examine problems, solution-focused brief therapy (SFBT) its main aim is to find solutions based on present time and knowing the hopes for the future for an individual to offer a solution to the client.  According to this method, an individual is supposed to know what he or she needs to get the solution to the problem. To find quick and better solutions coaching and questioning are used. SFBT is used to treat individuals of all ages and various issues example child abuse, addiction, behavioral problems and family dysfunction (Kim, 2013, p.32). Also, SFBT is used to improve the lives of people with depression and schizophrenia disorders. Narrative therapy is a type of counseling where people and problems are viewed as entirely different. This makes the victims move away from the issue and watch whether it is helping them.  Narrative therapy is used by couples, families, and individuals who define themselves by their problems. I have learnt from the counseling topic that I t is essential to go for counseling if need arise because it helps one to be able to know his her problems and be able to sort them out.

            What I Found Most Valuable

            Listening or observing is the most thing I found valuable in the counseling skills in the therapeutically relationship. Where the therapist is willing and able to meets the clients, he or she is supposed to listen carefully. It is vital for the therapist to ask questions to be able to learn more about the client. Also, the most valuable thing I learned is that as therapist one should be able to use reflection in the counseling process thus helping the person to explain client state. The therapist should try and remain genuine when interacting with the client. 

            What Challenged Me

The challenging thing about the counseling process is that the therapy talk and meeting different kinds of clients does not make one feel better. Finding a breakthrough is suitable for the therapist and the client though it does not come easy. Therefore achieving the goal, one has to be courageous and unafraid. Remembering memories and experiences or even changing a client behavioral style can be demanding, disturbing and overwhelming.

            What I Want To Know More About

Given that counseling is a broad topic, I want to know whether counseling therapy is forever or there is a stage where the client will stay without the therapy sessions. Also, after the counseling processes will the client be able have a healthy life such as to do away with depression, anxiety and related problems.

Conclusion

    In conclusion, counseling course has taught me that it is okay to listen to victims without jumping to the conclusion this will help one to achieve simplicity and clarity of what the client need. Also as a therapist, one should always show support for client’s feelings by being aware of the victim emotional responses.  Also, individuals should offer their personal experiences to the clients to help them to share their problems without feeling guilty. When assisting an individual, it is good to give them time to express their feelings and ideas. This will help the therapist to get the appropriate information from the client. The advisor or therapist when necessary should use valid examples to express his or her feelings to the client.

References

Carlson, J., Watts, R. E., & Maniacci, M. (2006). Adlerian therapy: Theory and practice. Washington, DC: American Psychological Association.

 Hobson, R. P. (2016). Brief psychoanalytic therapy. Oxford, United Kingdom; New York, NY, USA: Oxford University Press

Kim, J. S. (2013). Solution-focused brief therapy: A multicultural approach. Thousand Oaks: SAGE Publications, Inc.

 Persons, J. B. (2012). The case formulation approach to cognitive-behavior therapy. New York: Guilford Press.

Quinn, A. (2015). A person-centered approach and the Rogerian tradition: A handbook. San Bernardino, California: CreateSpace.

Introduction

Depression is a common and major clinical disorder that comes with severe symptoms that affect how a person feels, thinks or even handle their normal activities like eating, sleeping or working.  Depression among the elderly people can be related to Psychotic Depression or Bipolar Disorder. Psychotic Depression involves an individual having some kind of psychosis like delusions, seeing things that are upsetting with some depressive themes like illness. Bipolar disorder may differ from depression but it’s associated with the condition because a person experiences very low moods episodes that can be considered depression.  The biological changes resulting from aging occur slowly over time which means that at whatever age people may be considered elderly, they may experience depression. Due to the related devastating consequences, depression in late life is an important issue in public health. The condition differs from the depression experienced when people are younger in obvious and subtle ways.  The level of Depression has also been found to be more common among the elderly people who are placed at healthcare home homes and can come in form of functional impairment, increased medical illnesses and pain.  Even though older adults are at higher risks of suffering from depression, it is a medical condition that can be treated since it is not a part of normal aging process.

Problem Statement

There is a higher risk of elderly people to suffer from depression given that normally, almost 80 percent of older are undergoing at least one health condition that is chronic and 50 percent will have at least two health conditions (Sözeri-Varma, 2012).  In addition, depression is found more among those individuals who suffer from other diseases like cancer or heart disease and whose body functionalities are limited (C. D. C., n.d).  Around the globe, the population is rapidly aging and it is estimated that the 2015-2050 period will see the world population percentage of people over 60 years almost double to 22 percent from 22 percent. This indicates increased risk of more people suffering from depression (Mental Health America, 2018). In US even though the proportion of older individuals suffering from depression and living within the community is between 1 percent and 5 percent, it tends to rise to 13.5 percent among those individuals who are in need of home healthcare and increase to 11.5 percent of elderly patients in hospitals.  The proportion of older patients who shows depression related symptoms normally have about 50 percent more healthcare costs than elderly people who are not depressed (Mental Health America , 2018).  Depression has also reported to be a great predictor of suicide cases among these individuals. A comparison of the 13 percent of United States population, people who are 65 years older or above make up a whole 20 percent of the reported suicide deaths especially among the white males (Mental Health America , 2018).  There is lack of sufficient knowledge about this condition among the older population and some do not the issue as a health problem. Only about 68 percent of 65 years and above adults have little to no knowledge about the condition. Also only 38 percent of these see the condition as a health problem (Mental Health America, 2018).  This means that older adults suffering from depressions are more likely to take care of themselves than other groups in the population. This calls for a health plan for informing the individuals and their families about depression, the need for personal care and available solutions.

Current solutions

 Caring for the elderly people with depression is done by various healthcare facilities and community organizations with Centers for Disease and Control Prevention playing a significant role especially while trying to incorporate mental health and the overall public healthcare.  The healthcare services are provide through a collaborative approach, where the Healthy Aging Program by CDC has been linking the various departments of public health with a network of aging services offered for the aging people with mental health problems (C. D. C., n.d).  The CDC plays a role of collecting information with an aim of monitoring the impact of depression on elderly people, assisting various states to access data at local and state level, collecting evidence used in community-based programs and facilitating interventions that are evidence based and which can assist the older people to maintain their health outcomes (C. D. C., n.d).  The public health community consists of healthcare facilities and community-based organizations which come with many benefits to geriatric patients.  The healthcare services are offered through many local Community-Based organizations like Area Agencies on Aging, Senior Centers, Day Centers, Faith- based Organizations and Social Services Agencies (Coleman, Whitelaw & Schreiber, 2014). These organizations provide healthcare services to elderly people with individuals more effectively given their convenient locations in a community and such services are tailored to older population’s individual special needs (Coleman, Whitelaw & Schreiber, 2014).  

The Public Health Community also collaborates with various ageing services and providers of mental health so that they can readily reach the older adults suffering from depression.  In the health care facilities, regular and systematic screening is done since they can effectively point out adults with depression and then, the patients are directed to seek appropriate treatment. An important aspect in caring for these individuals involves the use of Behavioral Risk Factor Surveillance System that involves a questionnaire. As the largest telephone system for healthcare survey, it is used to track any risk behaviors or health conditions in US (C. D. C., n.d).  This tool includes a question about number of days people experience depression and stress and thus highlighting the trend of condition among the older people.  Collecting information from organizations such as U.S Surgeon General has helped in determining the effectiveness of ht available interventions for mental disorders like depression and the causing factors like bereavement (C. D. C., n.d).  

The use of home-based care management for depression or clinic based care has been recommended by these bodies using the evidence collected about the condition.  Previous the federal government through White House Conference on Aging implemented a decision on the enhancing the identification, evaluation and treatment of depression among the elderly in Americans.  The attention given to mental health issues like depression among older adults has ensured that there is collaboration between Mental Health Systems and public health (C. D. C., n.d). Before then , public health emphasized on surveillance for various chronic diseases like depression so as to come up with public healthcare programs , which had led to field of mental health using a different system to collect data . Such a system focused on measuring the prevalence of the disease and use of health care. The new approach aimed at incorporating all systems have comprised of addition of measures of chronic disease. The use of Identifying Depression, Empowering Activities for Seniors (Healthy IDEAS) is a model for Depression Care Model is a major model used by healthcare community (C. D. C., n.d). The focus of this program is on adults who 60 years and older in the community and who are considered frail and underserved and in need of Care Management Services. The depression care for the participants is provided by the program in their homes.  It involves providing the education necessary in the process of depression related assistance in linking with mental health and primary care providers and self-care to participants and caregivers. It also offers support and coaching while the client is engaging in various changes in behavior that would enable management of depression and pursuit of meaningful activities.  This intervention does not require professional licensing and normally includes an on-site training for these individuals (C. D. C., n.d).

 Another solution involves the use of Improving Mood Promoting Access to Collaborative Treatment (IMPACT), a program that offers Depression Care Management that is clinically based for depressed older adults.  The care givers involved in the program comprises of a trained nurse, a psychologist, social worker and primary care doctor (C. D. C., n.d). The Psychologist teachers the participants on various techniques for solving problems and the doctor can administer the necessary anti-depressant medications. Another intervention program involves the use of Program to Encourage Active, Rewarding Lives for Seniors ( PEARLS) that involves provision of Depression Care Management that is home-based to adults with 60 years and above , who have been beneficiaries services offered by community agencies at their homes (C. D. C., n.d).  The program provides 8 counseling sessions, and about 3 to 6 phone calls for follow-up maintenance.  The program is ran by a Depression Care manager who has the right training and mostly consists of a counselor and social worker , and involves the employment of problem-solving treatment , planning of physical and social  activity and also planning of pleasant-event. The care manager works in collaboration with a psychiatrist who is also a supervisor (C. D. C., n.d).

Analysis of Local Solutions

 The Kathrine’s place, an organization that cares for the elderly also provides care services for those suffering from depression.  The Depression Care Management program at the organization involves the collection of data about elderly individuals’ physical, social, emotional status and particularly their health conditions. This information assists in understanding the mental health of the person and whether they are suffering from depression. Correction of data or information on the health status of elderly people is the first step in developing programs that allows for personalized healthcare in the organization.  The questions in this tool are important in understanding the different functional characteristics that define the extent to which a person is suffering from depression. These ranges from  difficulties in reading and carrying out personal chores such as dressing , eating , complex tasks like finances , health issues such as fecal and urinary incontinence and even speeches.  The Depression Management care at Katherines Place involves providing an environment for socialization to prevent isolation, engaging individuals in various activities to keep the patients busy and thus, direct their attention away from their problems such as bereavement. In extreme case, where the depression level is high, the care givers provide the depressed elderly people with medications to ease the condition or even enable them to eat properly. The program is also based on collaboration with the family members of the elderly people so they are visited regularly which goes a long way in reducing the feelings of Isolation.  The collaboration with the family members also helps in improving the care given to these individuals.  

There are various barriers that prevent program to reach many old adults in the community for treatment of depression. The barriers keep program used by the organization from being used. A major barrier is social stigma especially against individuals who are mentally ill. Some people in the community consider depression as a character flaw or personal weakness which makes the older adult to be reluctant in seeking mental health care. The older persons also have negative attitude towards seeking help for mental health disorders and related treatment which they may view as shameful and/ or relate this to personal failure. Given that an individual’s loss of autonomy has been observed to be a major risk factor for depression, these individuals may resent seeking help from the center as they attempt to take care of themselves or regain their freedom.  Hence, they can even deny having mental health problems and embark an attempt to personal care.  Another issue involves cost of care, since insurers such as Medicare only provide depression cover only if the care is offered by psychologists or physicians and any RN practitioner.  Without enough funds, it becomes hard for care givers to provide care givers who are well trained and under supervision. This means that as much as the Katherine Place Depression Care Management program is focused on assisting these individuals in the community, they may not have the capacity and the capability to provide appropriate care to the patients, which hampers the adoption of the various programs.

Conclusion

There is a higher risk of elderly people to suffer from depression than any other group in the population. Due to the related devastating consequences, depression in late life is an important issue in public health. The current solutions involve collaboration in public health community, between CDC and the various Community Based Organizations and agencies to implement various programs for caring for the depressed elderly people. The CDC collects evidence on elderly people suffering from depression and such information is used in development of care giving programs.  Since depression can lead to more complications for other diseases among the elderly people, it is important to have effective and personalized care that is evidence based. The Depression Management Care should also address the stigma, attitude and cost barriers that prevent organizations from reaching more elderly and depressed individuals in the community. This should involve intensive education of the participants about the need for seeking healthcare and epically change their attitude on loss of personal autonomy.

Part 2

Public Service Announcement

We cannot control or prevent ourselves from aging, put we can control out experiences of the aging process. By undertaking tests on depression and seeking professional assistance, we can embrace our late lives positively but not as a sign of personal flaws. For more information contact the nearest care giving center or agency.

References

At, C. D. C. (n.d). "CDC Promotes Public Health Approach To Address Depression among Older Adults."

Coleman, E. A., Whitelaw, N. A., & Schreiber, R. (2014). Caring for seniors: How community-based organizations can help. Family practice management, 21(5), 13-17.

Centers for Disease Control and Prevention. (2012). Depression is not a normal part of growing older. Healthy Aging.

Mental Health America , (2018).Depression In Older Adults: More Facts. Retrieved from: http://www.mentalhealthamerica.net/conditions/depression-older-adults-more-facts

Sözeri-Varma, G. (2012). Depression in the elderly: clinical features and risk factors. Aging and disease, 3(6), 465.

Appendix

Interview Questions - Summary

1. Do you believe depression is a major problem among the elderly persons today?

Yes - Just as Some residents are depressed

2. How do depressed older people behave different?

   Symptomatic – anger, harsh to staff

3. What are the Risk factors to depression among the elderly?

Change in health standards and living standards where can no-longer care for themselves

Illnesses that affect comprehensions of things including their surroundings

Loss independence, loss of family, friends

Loss of autonomy – They do not want help and keep it to themselves

Other complications such as Bi-polar disorders which makes them confused and upsetting to people around them

Those who served in combat war, PTSD, recurring nightmares, horrific experiences

Women – if it’s a couple , the husband is declining faster than wife and she starts worrying, she cannot care for him – showers , meals , medications but experience him sleeping away , comparing their situations with those of others

4. What is the Role of nurses in reducing risk factors among aging population?

 Conducting Good assessments , being vigilant , collaborating with residents regard to symptoms ,such as change in eating and sleeping habits ,

• Encouraging families to visit often , engaging older people in activities , ensure they are having friends to prevent isolation

5. How is insomnia related to depression among the elderly?

-Less sleep become clumpy, more confusion, confused nights and sleeping all days, not enough rest

 Is depression more common among aging women or men?

There more depressed women in nursing homes

15 women but more men at Katherine’s place

7. How do you perform Screening and administer treatment?

Screening everyone for depression, check their level, monitor them on how there are doing socially, preventing them from being Isolated, XOLOft, PROZAC, sleeping medication

Medication – so that they eat well 

Stevens District Hospital SWOT analysis

            References

            Ernst & Young. (2009). Performance Audit Report: Three Public Hospital Districts

Valley Medical Center, Evergreen Healthcare, Stevens Hospital. UK.

Addiction and Rehabilitation

12-step programs is a treatment plan that was developed by Alcoholics Anonymous to address addictions to drug use. The Alcoholics Anonymous established the 12 steps to overcome addiction to drug use, and other addiction support groups were formed and created their own 12 steps. Other 12-step programs include; Narcotics Anonymous, Celebrate Recovery, Cocaine Anonymous, Heroin Anonymous and more (Gallas, 2003). The founder of the 12-spets program came from the Oxford Group Movement; a movement that taught people to confess their sins and spread the religious message. Even though the groups are religious, it does not support or force people to follow the religious doctrines, but it teaches people to follow their religious doctrines. The twelve-step programs participate in recovery support process to assist the individuals to recover from addiction. The 12-step programs from the various support groups such as the Alcoholism Anonymous believe that people are unable to manage their lives but, moral inventory, personal inventory and spiritual awakening would remove the defects (Gallas, 2003)..

 However, the court believes that the 12-steps programs have drawbacks. The court argue that the 12-Step programs are religious and the Alcoholism Anonymous does not focus on helping individuals cope with addiction but it tends to proselytize (convert the individuals from own religion to another). The support group was founded from a monotheistic religion where they believe on all-powerful God. The problem with the programs is that they have developed the unconstitutional establishment of religion and violated the Establishment Clause (Gallas, 2003)..  The court argues that individuals are forced to join religious practices, and this is a violation of First Amendment human right to religious activities.

            Fiorentine (1999) states that the 12-Steps programs have shown an extraordinary rise and, have given rise to conventional treatment. Various studies show that individuals who participate in 12-step programs maintain abstinence within 6month, 12-month and 1 to 2 years period.  The data that shows the effectiveness of the 12-step programs is derived from the Los Angeles metropolitan areas through a longitudinal assessment. The findings from the study showed that individuals who participated in 12-step programs reported the low level of alcohol use.  Overall, individuals experienced drug and alcohol abstinence within 6-month (Fiorentine, 1999). For example, only 27% participants used abused drug compared to 44% who did not participate in the 12-step program.  Precisely, 32% of participants abused alcohol in 6months compared to 61% of those who never participated (Fiorentine, 1999). In 24-month follow up, only 4% of participants drank alcohol compared to 13% of non-attenders. The finds show the effectiveness of the 12-step program in that those who participated in the 12-step program reported  drug and alcohol abstinence.

Initially, the 12-step programs were designed to help those with addictions but, they are also appropriate to rehabilitate a probationer. Note that the programs use therapeutic approach elements where they assist the offenders with social and psychological change (Gallas, 2003. The importance of 12-Step programs for probationers is to offer practices and beliefs and help the offenders live an abstinent lifestyle.  Parolees and probationers may be suffering from anxiety and depression and, the support groups will play a significant role in providing the ex-offenders will long-term recovery.  In general, offenders who are not addicts also need the 12-steps programs to provide psychological interventions and help offender lead meaningful lives (Gallas, 2003).

              The act of removing the problem that causes terrible behaviors might not deter the crime. This is supported by the rational choice theory which states that offenders make the decision and decides to commit a crime to benefit themselves. In committing a crime, the offender must have rational choices and routine activities and consider both risks and reward. In other words, deviance is a purposeful behavior and criminals choose to behave in a certain way (McLaughlin & Muncie, 2005)

References

McLaughlin, E., & Muncie, J. (2005). The Sage dictionary of criminology. London: SAGE.

Fiorentine, R. (1999). After drug treatment: Are 12-step programs effective in maintaining

abstinence?. American Journal Of Drug & Alcohol Abuse, 25(1), 93.

Gallas, E. M. (2003). Endorsing religion: Drug courts and the 12-step recovery support program. Am. UL

Rev., 53, 1063.