Children’s Functional Health Pattern Essay Example for Free

Children’s Functional Health Pattern Essay Toddlers believe rules are absolute and behave out of fear of punishment. The toddler will respond with good behavior for positive feedback. These  values and beliefs are learned. Preschoolers frequently express their values by stating who or what they like or what they want to be when they grow up. Preschoolers receive modeling of values from involved adults, peers, as they develop their morality. School-Age children’s values come from religion, cultural, and parental values influences. These factors shape a child’s moral development, and concept of right and wrong. School-age children are able to make decisions related to moral and ethical issues. Parents may cater to their toddler when they are misbehaving, giving them more attention when they are bad than when they are good. This make the toddler believe that behaving badly gets their parents attention. Parents need to remember to reward good behavior, and to emphasize rewards for acceptable behavior and minimizing attention for unwanted behavior. Parents may not have firm and established rules, making it confusing for the toddler to distinguish right from wrong. Peers or inappropriate content on television can negatively influence preschooler’s values and beliefs. Parents may have a poor morals and value system themselves, inadvertently teaching their preschoolers the same behaviors. School-age children may bend to peer pressure to gain the acceptance of their peers. School-Age children may cheat due a desire to win, or pressure from their parents and peers to be great. Short Answer Questions Address the following based on the above assessment findings. Expected answers will be 1-2 paragraphs in length. Cite and reference outside sources used. 1) Compare and contrast identified similarities as well as differences in  expected assessment across the childhood age groups. Across the stages of development from toddler up to school age children there is a significant difference in the amount of guidance needed and the amount independence required. The differences are evident when examining how each developmental phase interacts and responds within each health assessment pattern. Toddler and preschool children need more structure and routine, whether it’s brushing their teeth or bedtime rituals. School-aged children, on the other hand, require more independence and trust in decisions while still being guided and reassured as the develop their own sense of identity. There are similarities as amongst the age groups as well, such as all of the children moving towards a state of autonomy and the ability to express themselves adequately and be heard by either their parents, their peers, or both. Additionally, all of the different age groups have the need for a structured and healthy home environment in order to grow and develop. 2) Summarize how a nurse would handle physical assessments, examinations, education, and communication differently with children versus adults. Consider spirituality and cultural differences in your answer. When the nurse is caring for a child, the nurse must remember that they are essentially caring for the child and the parent (Jarvis, 2012). For a nurse, the assessment, examination and interaction with a child patient offers its own set of challenges and requires a different approach from that of an adult. When dealing the toddler and preschooler, the nurse should visit with the parent first, letting the child size the nurse up. The nurse can assess child on how they interact and react to the parent and the nurse. This allows the child to see that the caregiver has accepted and trusts the nurse. For the toddler and the preschooler, the parent will be providing most, if not all of the health history. When beginning the physical assessment on the child, move slow and approach them slowly while seeming happy and unthreatening. The nurse should allow the child to hold instruments, like a stethoscope, during the physical exam to help them feel like they are involved in their own care. Having parents there add security and support for children, and also can help with the ease of assessing the  child without them realizing that they are being assessed. With children of each stage of development, the nurse must be cognizant of verbal and non-verbal cues provided by the child. The nurse should be mindful that there could be cultural and/or spiritual considerations to take into account, like when undressing a child of the opposite sex. The nurse needs to ensure that the caregiver and the child feel comfortable. With both children and adults, assessment should start with least invasive and progress leaving most invasive last. School-Age children should be assed like either children or adults depending on their developmental age. Adult assessment can be more direct than that of a child. Ask adults open ended questions, listen to their complaints, and educate as needed. References Current Nursing. (2012). Theory of Psychosocial Development: Erik H. Erikson. Retrieved From http://currentnursing.com/nursing_theory/theory_of_psychosocial_development.html Edelman, C., Kudzma, E., Mandle, C. (2010). Health Promotion throughout the Life Span [VitalSource Bookshelf version]. Retrieved from http://pageburstls.elsevier.com/books /9780323056625 Jarvis, C. (2012). Physical Examination and Health Assessment [VitalSource Bookshelf version]. Retrieved from http://pageburstls.elsevier.com/books/978-1-4377-0151-7

Eye Strain as a Result of Computer Use :: Technology Computers Health Vision Essays

Eye Strain as a Result of Computer Use In the twentieth century, technology is at an all time high in the world. This technology includes research, stock market shares, computers, medical advances, and a vast variety of other things. Among the advanced technology is a break through of computer use. Almost everyone at sometime in their day is using a computer for one task or another. Computers have taken the world and reshaped the possibilities of ideas and dreams in the past decade. Millions of people are using a computer daily according to Anshel (1996). This work on the computer can ran range from five minutes a day to eight hours a day depending on they type of job a person holds. Today's job market, employees are accustomed to working with a computer. This could include data entry clerks, an internet consultant, a bank teller, a librarian, and especially secretaries. The field is open to just about anyone. Often overlooked are the students that use computers on a daily basis. Many college students depend on the use of computers classes whether it be for fun or recreational use. Sometimes the convience of using computers comes with a high price to pay. The National Institute of Occupational Health and Safety (NIOSH) says that eyestrain is the leading problem in computer use. This even exceeds such common problems as carpal tunnel syndrome. (Atencio 1996) Eyestrain and eye fatigue lead to many other complications if it is a continuous problem. One of these problems includes myopia. There are many ways of relieving eye fatigue and helping the symptoms of myopia. These problems can be onset in younger years when children are in school. Since most schools in the country are using computers as a main source of education, eyestrain can be a linked to myopia. There are many options people or companies have to improve the conditions under which the person is working. Eyestrain is defined as blurred or double vision, burning, irritation, headaches, gritty eye sensation, eye fatigue, neck and shoulder pain, color perception change, decreased visual efficiency, more frequent errors and reduced efficiency. (Atencio 1996, Palmer 1993, Nunoo 1997) Eyestrain is also known as asthenopia. It simply means visual strain. (Palmer 1993) Dr. Paul F. Bommarito also said that 88% of heavy computer users experience these problems. (Fletcher 1996) Palmer suggest that eye fatigue is often caused by the eye muscles becoming tired much like other muscles in our body.

Health Law and Regulations Essay

In understanding regulatory agencies the differences between regulation and legislation needs defining. Legislation is the law that has been passed by a voting process and regulation is the responsibility of the regulatory board appointed to enforce laws once the law is passed; it sets forth rules on how the laws are to be implemented and to what degree. In health care the Department of Health and Human Services (HHS) has the predominant responsibility to enforce legislation that impacts the health and well-being of Americans. Under the umbrella of HHS there are 13 regulatory agencies tasked with setting rules on the enforcement of the legislation passed by lawmakers. Regulatory Agencies Two of the most influential regulatory agencies within HHS are the United States Food and Drug Administration (FDA) and the Center for Medicare and Medicaid Services (CMS), these two agencies have substantial influence on every aspect of health care delivery. The FDA is responsible for protecting and promoting public health through the regulation and supervision of food safety, medical devices, drugs, vaccines, blood products and biologics. In addition, they monitor medical errors and adverse reactions and reporting such to providers, (U.S. Department of Health and Human Services, 2011). CMS controls the Medicare program and works in collaboration with state governments to oversee Medicaid, and the State Children’s Health Insurance Program (SCHIP). In addition to these responsibilities, CMS dispenses criteria from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), surveys and certifies quality standards in long-term care facilities, and clinical laboratories, (Centers for Medicare and Medicaid Services). The proportion of national health spending sponsored by both federal, state, and local governments was 45% in 2010, a significant source of revenue depended on by providers of health care, (Centers for Medicare and Medicaid Services, 2011). Current FDA Regulations The Patient Protection and Affordable Care Act (PPAC Act), amended the Public Health Service Act (PHS Act) to create a shortened authorization route for medications found to be â€Å"highly similar† or â€Å"interchangeable† with an FDA-approved medication, (U.S. Department of Health and Human Services, 2011). The goal is similar to the Drug Price Competition and Patent Term Restoration Act of 1984 (â€Å"Hatch-Waxman Act†), which produced condensed methods for the approval of drug products under Federal Food, Drug, and Cosmetic Act (FFD&C Act). The outcome is aimed at the FDA’s instituted policy of allowing confidence on what is already known about a drug, thus protecting time and resources, (U.S. Department of Health and Human Services, 2011). To help increase access to affordable prescription medications, the FDA implemented measures to expedite the development and approval of generic drugs. Generic drugs cost 50 to 70% less than their brand-name counterparts equating to a savings of eight to ten billion dollars a year at retail pharmacies, (Crawford, June). These savings do not include the use of generic drugs in an institutional setting. PPAC expands on the practice of generic drugs and incorporates using medications that have the same efficacy as another more expensive medication leading to more options in the prescribing of medications. The practice of using generic drugs is not without concern. As evidenced by the case Pliva v. Mensing where the question was; the safety standards for brand-name drug labeling also apply to generic-drug manufacturers. The patients in the case took the generic drug metoclopramide and developed tardive dyskinesia, which was listed on the label. The patients argued the warning was not adequate and the manufacturer argued the â€Å"changes being effected† process was not available to generic-drug manufacturers because the FDA requires labels for generic versions of drugs to be identical to those of the brand-name drugs, (Glantz & Annas, 2011). The FDA upheld the manufacturer’s claim although the FDA added the manufacturer had a responsibility to request a label change if the manufacturer knew a stronger warning was needed to market the drug safely. The court found in favor of the manufacturer stating â€Å"federal law still preempted injured patients from bringing lawsuits in state courts, because the state laws in question require a safer label, not communicating with the FDA about the possibility of creating a safer label,† (Glantz & Annas, 2011, p. 682). Despite this regulatory standing, a controversial issue may entail for the FDA in the allowance of medications to be â€Å"interchanged† to promote an additional avenue for savings in prescription medications. Much foresight needs to be included to protect the safety and well-being of patients. Current CMS Regulations The Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009 (ARRA), is legislation aimed at the adoption and â€Å"meaningful use† of health information technology. CMS was authorized to establish incentive programs for eligible Medicare and Medicaid providers who adopt, implement, upgrade, or â€Å"meaningfully use† certified electronic health records (EHR). The term â€Å"meaningful use† is an acknowledgement that improved health care is not the product of technology but a method to exchange and use health information to support clinical decisions at the point of care. To qualify for CMS’ incentive program the provider must obtain certified electronic health record technology. An incentive of $44 thousand can be achieved by an eligible professional who shows â€Å"meaningful use† over a five year period. Hospitals implementing a certified EHR system can qualify for a t wo million dollar base payment. In 2015 Medicare will implement a reduction in payment to those not displaying â€Å"meaningful use†. The decrease in payment begins at one percent and rises each year that hospitals and providers receiving Medicare payments do not make evident â€Å"meaningful use,† to a maximum reduction of five percent, (Centers for Medicare and Medicaid Services, 2011). The use of EHRs is encouraged by touting improved efficiency, cost-effectiveness, quality, and safety of health care delivery. A study on the use of EHR in 2952 hospitals in the United States revealed 12% of hospitals had instituted electronic physicians’ notes across all clinical units and 17% had instituted computerized provider-order entry for medications in all clinical units, (Jha, et al., 2009). The cited barriers to implementation of EHR were inadequate capital (74%), maintenance costs (44%), resistance of physicians (36%), unclear return on investment (32%), and lack of available staff with expertise i n information technology (30%), (Jha, et al., 2009). Ironically, the hospitals who had implemented the use of EHRs cited financial reasons such as additional compensation for electronic health record use (82%) and financial enticements for implementation (75%), (Jha, et al., 2009). The estimated cost of purchasing, installing, and implementing an EHR system in a provider’s office is approximately $40,000 and this figure does not reflect the cost of maintenance, (Blumentha, 2009). A survey by the American Hospital Association revealed â€Å"the median annual capital investment on information technology was over $700,000 and represented 15% of all capital expenses. Operating expenses were much higher at $1.7 million, or 2 percent of all operating expenses,† (National Institutes of Health, 2006, p. 18). Although there are indisputable reasons for implementing an EHR system, CMS’ incentive program is merely a pittance compared to the ongoing costs of operational expenses. The concept of all health care providers possessing an EHR system is ideal. As with any form of electronic technology comes the prospect of personal information being violated. The Health Insurance Portability and Accountability Act (HIPAA) does provide for penalties from $100 to $1.5 million, depending on the violation and whether it was done unknowingly or willfully and can include imprisonment up to 10 years. HIPAA protects the health information of individuals; â€Å"it does not create a private cause of action for those aggrieved,† (The General Counsel Department of Health and Human Services, 2005). Conclusion Federal regulatory agencies are a necessity to interpret and assist in the implementation of legislation. Without federal regulatory agencies the United States would have over 50 different interpretations on one piece of legislation. The FDA and CMS play a significant role in the ever changing health care arena. The FDA is based on scientific integrity evidenced by the recent publication of defined key principles of scientific integrity. Through this commitment to scientific integrity and quality the FDA provides medical safety to the American people. Through research and establishing guidelines the FDA has been instrumental in making generic drugs available to the public, saving them more than eight billion dollars annually. The PPAC tasked the FDA has been tasked with expanding on the generic drug practice by discovering medications that have the same efficacy as another medications leading to more cost saving options in the prescribing of medications. CMS has been tasked with implementing HITECH that has the promise of decreasing costs and errors in health care delivery. This is a lofty goal with over 80 percent of the United States hospitals without any type of electronic health record in place. The financial incentive provided by the federal government through CMS does not seem to be enough of a motivator to encourage the financial commitment of an EHR. Although, after 2015 when hospitals and providers have not demonstrated â€Å"meaningful use† these providers of Medicare services may be more inclined when losing one percent of their Medicare payments. These regulatory agencies and the legislation cited in this paper are a minute representation of the responsibility and obligation the federal agencies have to protect the well-being of the American people. The cited legislation delegated to these regulatory agencies is not only focused on health but financial constraint and safety of the American people. References Blumentha, D. (2009, April 9). Stimulating the Adoption of Health Information Technology. Retrieved from The New England Journal of Medicine: http://www.nejm.org/doi/full/10.1056/NEJMp0901592 Centers for Medicare and Medicaid Services. (2011, October 17). Medicare and Medicaid EHR Incentive Program Basics. Retrieved from CMS.gov: https://www.cms.gov/EHRIncentivePrograms/35_Basics.asp Centers for Medicare and Medicaid Services. (2011, September). National Health Expenditures 2010: Sponsor Highlights. Retrieved from CMS.gov: https://www.cms.gov/NationalHealthExpendData/downloads/sponsors.pdf Centers for Medicare and Medicaid Services. (n.d.). About us. Retrieved from CMS.gov: http://www.cms.gov/home/aboutcms.asp Crawford, L. (June, 23 2004). The Law of Biologic Medicine. Retrieved from FDA: http://www.fda.gov/NewsEvents/Testimony/ucm113745.htm Glantz, L., & Annas, G. (2011, August 25). Impossible? Outlawing State Safety Laws for Generic Drugs. Retrieved from The New England Journal of Medicine: http://www.nejm.org/doi/full/10.1056/NEJMp1107832 Jha, A., DesRoches, C., Campbell, E. G., Donelan, K., Rao, S., Ferris, T., . . . Blumenthal, D. (2009, April 16). Use of Electronic Health Records in U.S. Hospitals. Retrieved from The New England Journal of Medicine: http://www.nejm.org/doi/full/10.1056/NEJMsa0900592#t=articleBackground National Institutes of Health. (2006, April). Electronic Health Records Overview. Retrieved from National Institutes of Health: http://www.ncrr.nih.gov/publications/informatics/EHR.pdf The General Counsel Departmentof Health and Human Services. (2005, June 1). SCOPE OF CRIMINAL ENFORCEMENT UNDER 42 U.S.C.  § 1320d-6. Retrieved from The United States Department of Justice: http://www.justice.gov/olc/hipaa_final.htm U.S. Department of Health and Human Services. (2011, November 16). FDA Fundamentals. Retrieved from About FDA: http://www.fda.gov/AboutFDA/Transparency/Basics/ucm192695.htm U.S. Department of Health and Human Services. (2011, March 10). Implementation of the Biologics Price Competition and Innovation Act of 2009. Retrieved from U.S. Food and Drug Administration: http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/ucm215089.htm

U.S. Birth Rate Hits All-Time Low in 2016

In a trend that has some demographers worried, the birth rate in the United States dropped to its lowest level ever in 2016. Dropping by another full 1% from 2015, there were only 62 births per 1,000 women aged 15 to 44. Overall, there were a total of 3,945,875 babies born in the United States during 2016. â€Å"This is the second year that the number of births has declined following an increase in 2014. Prior to that year, the number of births declined steadily from 2007 through 2013,† noted the CDC. According to an analysis issued by the National Center for Health Statistics of the Centers for Disease Control and Prevention (CDC), birth rates in all age groups under age 30 fell to all-time record lows. Among women ages 20 to 24, the decline was 4%. Among women ages 25 to 29, the rate fell 2 percent.   Drop in Teenage Pregnancy Drives Trend In an analysis issued by the National Center for Health Statistics, researchers report that birth rates declined to record lows in all groups under age 30. Among women ages 20 to 24, the decline was 4 percent. For women 25 to 29, the rate fell 2 percent. Driving the trend, the fertility and birth  rate among teenagers and 20-somethings fell by 9% from 2015 to 2016, continuing a long-term decline of 67% since 1991. While they are often used interchangeably, the term â€Å"fertility rate† refers to the number of births per 1,000 women between the ages of 15 and 44 occurring in a particular year, while â€Å"birth  rate† refers to the fertility rates within particular age groups or specific demographic groups. Does This Mean the Total Population is Falling? The fact that the all-time low fertility and birth  rate puts the United States population below the â€Å"replacement level† — the balance point between births and deaths at which the population exactly replaces itself from one generation to the next — does not mean that the total U.S. population is falling. The annual U.S. immigration rate of 13.5% in 2017 still more than compensates for the lower fertility rates. Indeed, while the birth  rate continued to fall consistently throughout the period from 1990 to 2017, the nation’s total population increased by over 74 million people, from 248,709,873 in 1990 to an estimated 323,148,586 in 2017. Potential Dangers of a Falling Birthrate  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Despite a growing total population, some demographers and social scientists worry that if the birth  rate continues to slide, the U.S. could face a â€Å"baby crisis† resulting in cultural and economic pathos. Far more than an indicator of societal trends, a nation’s birth  rate is one of the most significant gauges of its overall demographic health. If the fertility rate falls too far below the replacement level, there is a danger that the nation will lose the ability to replace its aging workforce, leaving it unable to generate the amount of tax revenue needed to keep the economy stable, maintain or grow the infrastructure, and become unable to provide essential government services. On the other side, if birth  rates get too high, overpopulation can strain the nation’s available resources such as housing, social services, and safe food and water.   Over the decades, countries like France and Japan, experiencing the negative effects of a low birth  rate have applied pro-family policies in attempts to encourage couples to have babies. However, in nations such as India, where fertility rates have fallen slightly over the last few decades, residual overpopulation still results in wide-spread starvation and abject poverty. US Birthrates Up Among Older Women The US birth  rate is not falling among all age groups. According to the CDC’s findings, the fertility rate for women ages 30 to 34 rose by 1% over the 2015 rate, and the rate for women ages 35 to 39 went up by 2%, the highest rate in that age group since 1962. The birth  rate among older women ages 40 to 44 also increased, up 4% over 2015. In addition, the fertility rate for women ages 45 to 49 increased to 0.9 births per thousand from 0.8 in 2015. Other Details of US Birthrates in 2016 Unmarried Women: Among unmarried women, the birth rate fell to 42.1 births per 1,000 women, down from 43.5 per 1,000 in 2015. Falling for the eighth consecutive year, the birthrate for unmarried women has now dropped by over 3% since reaching its peak in 2007 and 2008. By race, 28.4% of white babies, 52.5% of Hispanics, and 69.7% of black babies were born to unmarried parents in 2016. Preterm Birthrate: Describing babies born before 37 weeks of gestation, the preterm birth rate increased for the second consecutive year to 9.84% per 1,000 women from 9.63% per 1,000 women in 2015.  This slight increase in preterm births came after a decline of 8% from 2007 to 2014. The highest rate of preterm birth was among non-Hispanic blacks, at 13.75% per 1,000 women, while the lowest was among Asians, at 8.63% per 1,000 women. Use of Tobacco by Mother: For the first time, the CDC reported data on mothers’ use of tobacco during pregnancy. Of the women who gave birth in 2016, 7.2% reported smoking tobacco at some point while pregnant. Tobacco use was the most common earlier in pregnancy — 7.0% of women smoked in their first trimester, 6.0% in their second, and 5.7% in their third. Of the 9.4% of women who reported smoking in the 3 months prior to becoming pregnant, 25.0% quit smoking before pregnancy.