Chronically Mentally III Population Essay Example for Free

Chronically Mentally III Population Essay The main focus of state and federal policies lies on the provision of support and long-term care services to the individuals with significant disabilities or those who are very old. These individuals, almost one and a half million, are taken care of in the nursing homes and Medicaid covers almost half of the total cost charged by nursing homes for their institutionalization (Tallon, 2007). While the total population of this special group of individuals only accounted for only 7 percent of the total population supported by Medicaid, it became expensive for Medicaid to support them as they accounted for almost half of the total expenditure of Medicaid. Policy makers therefore focus on changing the predominant service locus to community and home based from nursing homes (Diamond, 2009). Deinstitutionalization of individuals suffering from chronically mentally ill differs depending on the objectives and policies adopted from time to time. However, the interventions used to deinstitutionalize chronically mentally ill patients tend to share some lessons and parallels. History of chronically mentally ill population As state objectives and policies change over time, the history of the chronically mentally ill population in the United States has experienced significant transitions. Initial interventions, as from 1955 to 1980, policies and objectives were aimed at moving the chronically mentally ill individuals from the public mental hospitals owned by the state (Tallon, 2007). As a result of these efforts, the population of individuals residing in public mental health facilities reduced to 154,000 from 159,000 (Tallon, 2007). Later, there were approaches aimed at expanding and improving an array of services as well as supportive measures for chronically mentally ill in the community. There was massive closure of whole institutions which resulted to an increased emphasis on the rights which secured integration of the community. The rights that were emphasized included the right to have equitable access to housing (Bailey, 1999). States could fund small pilot programs since the community for those individuals who positively responded to antipsychotic agents which begun to be available. Thereafter, the national deinstitutionalization movement officially got launched through the programs for community mental health centers in 1965 (Tallon, 2009). Concerns over institutional conditions and the rights of citizens propelled further the need for the movement. The courts then limited the number of involuntary institutions and set minimum standards that were critical for institutional care (Diamond, 2009). The shift by states between sites of institutional care was fuelled by federal policy. The Commission on Mental Health Centers Construction (CMHC) program was intensively expanded in 1970s (Tallon, 2009). The coverage for Medicare and Medicaid was wide and it included mental healthcare services. Income support was mainly provided by the SSI (Supplement Security Income) program as well as the Social Security Disability Insurance (SSDI) (Tallon, 2009). The psychiatrist beds in community care increased in number after federal Medicaid provided sufficient funds as incentives. This saw the state moving individuals to the nursing home thus capturing the reimbursement from Medicaid which was not easy to find in mental hospitals of the states. In general, the overall progress of institutionalizing became immensely slow as the resources that were critical for community care. Until 1993, there were relatively fewer mental health dollars controlled by the state which served to assist in community care programs other than other state institution (Tallon, 2009). Although promising models of successful community care were provided and experimented, these models were rarely evaluated with rigor. They were also rarely integrated into the standard models (Tallon, 2009). The Nature of Chronically Mentally Ill Chronically mentally ill individuals suffer from bipolar disorder, schizophrenia, recurrent and sever depression as well as other several conditions which worsen their quality of living. A number of mental illnesses exist where some of them include schizophrenia, depression, dementia and bi-polar disorder (Szwabo, 2007). Individuals suffering from chronically mentally illnesses may present signs such as mental disturbances but these presentations vary depending on the type of disorder and age. Chronic mental illness produces major impairments in human functioning for a long period of time which normally covers the entire life span of an individual. For the chronically mentally ill individuals to get attention from the society, they require to negotiate with policy makers about a bureaucratic maze (Szwabo, 2007). A very ugly history about the chronically mentally ill patients exists where individuals used to be locked up and then forgotten. Today, there has been an emergence of state of the art hospitals, thanks to the historical forces (Bailey, 1999). The chronically mentally ill however, have been reported to face serious problems including incarcerations in the system of the criminal justice. This indicates how history is repeating itself and moving back to the pre-asylum ages when chronically mentally used to be locked in almshouses (Szwabo, 2007). However, the shift in the locus and pattern of mental healthcare that arise from the deinstitutionalization forces have all resulted in the missing link between the problem definition and modern efforts used to address the problem (Diamond, 2009). There also seems to be a lack of consensus on the clear mark lines which best define the chronically mentally ill individuals. There are no clear boundaries which can serve as a scientific guideline for national policy making process. Today’s approaches of treatment of the chronically mentally ill have incorporated trans-institutionalization, increased support from the family and the shunting into the system of criminal system (Szwabo, 2007). It is apparent that this special population seriously requires socialization, in-patient care and shelter. Common Clinical Issues and Interventions in the management of chronically mentally ill individuals Care provision to the chronically mentally ill needs adequate planning, trained and committed healthcare providers from both clinical and social capacities and financing programming. There are many issues which need to be resolved in order to tackle challenges facing effective management of chronically mentally ill patients. Some of these issues are parity for mental healthcare services, availability of mental healthcare provider, care planning and broader case management coverage, education and training in mental health, and warehousing of the patients (Szwabo, 2007). Lack of parity continues to be an issue in the provision of healthcare among mental healthcare providers. This is due to the low amount of reimbursement made to social and nursing work. There is an intense lobby for social workers and advanced nurses to be reimbursed differently. There is also an inadequacy for the provision mental healthcare services. For instance, the reimbursement for the psychotropic which is an essential part of chronically medically ill is still inadequate (Szwabo, 2007). There is need to provide medical treatments apart from the psychiatric treatment interventions. However, major problems such as lack of adequate geriatrics to address the rising population of the aged have always been a weakness to the management of chronically mentally ill patients. It is also observed that attending to chronically mentally ill patients in nursing homes require access to suitable mental healthcare amenities. Unfortunately in many situations, access to living facilities, programs, trained staff and oversight becomes difficult to afford. Education and training for mental healthcare professions is inadequate as they lack facilities for long-term care (Bailey, 1999). It then appears that most managed care programs for chronically mentally ill patients are poorly managed, designed and therefore do not offer the required standards. The traditional mental healthcare systems only focus on reducing the costs of operation while failing to address the important element of patient care. In a capitated mental healthcare, the systems prompt physicians and other caregivers to limit medications to the least minimum in an effort to only manage overt symptoms. The practice literally condemns chronically mentally ill patient to medical starvation doses (Bailey, 1999). Summary and Future Considerations While the incidences of chronically mentally illnesses have increased and their prevalence well documented, there are still problems related to the use and access of general medical care. For effective management of chronically mentally illness in the future, there should be proper education for the healthcare providers about the condition. Service planning, outreach and assessment are also important elements in improving the way the condition is being managed. Mental healthcare providers should perform good service delivery monitoring and advocacy. In case of limitations of healthcare providers, psychiatric nurses can take the roles of consultation and supervision. The nurse can also execute roles as a nurse practitioner and deliver services in primary care. In the society, members of the family having an individual suffering from the condition should not neglect him or her. Instead, they should care for and encourage the patients.

Akai MPC2000 (MIDI PRODUCTION CENTER) Essay -- essays research papers

AKAI MPC2000 MIDI PRODUCTION CENTER   Ã‚  Ã‚  Ã‚  Ã‚   The following is a summary of the advanced features of the AKAI MPC2000, which include a built in sampler, sequencer and more. Here is a detailed general description of the AKAI MPC2000. Large 248 x 60 dot LCD display with graphics. 6 functions keys under the LCD display provide various functions on each page. Built-in 1.44 megabyte floppy disk drive to store both sequences and sound data. Built-in SCSI interface for storing data to external hard disk. Here is a detailed description of the AKAI MPC2000’s built in sampler. 16-bit, 44.1kHz stereo sampling High capacity sound memory: 2 megabytes standard (22 seconds mono or 11 seconds stereo), expandable to 32 megabytes with SIMM memory. Digital sampling input for direct recording from digital sources with IB-M208P board. 128 sounds (samples) may be held in memory at one time. 32 simultaneous playback voices. The envelope or filter can be set for each sound. Optional multi-effects generator EB16 for versatile effects. Sample files may be loaded from AKAI S1000 and S3000 disks. IB-M208P (optional) enables you to mix and output internal sampler sounds from 8 individual outputs. A maximum of 24 programs (sound assignments and sound parameter settings) can be created. A selection between poloyphonic (multiple sounds are overlaid when the same sound is played continuously) or mono (the second sound silences the first). It is possible to stop the playing of a so...

Discovery and Conquest of America was achieved through the heroic acts of great men, is this myth or reality?

Before I discuss my stand about this matter, let me first tackle myth. As the definition, Myth (mythos) is a sacred story concerning the origins of the world or how the world and the creatures in it came to have their present form. The active beings in myths are generally gods and heroes. Myths often are said to take place before recorded history begins. In saying that a myth is a sacred narrative, what is meant is that a myth is believed to be true by people who attach religious or spiritual significance to it. Use of the term by scholars does not imply that the narrative is either true or false.A Myth in popular use is something that is widely believed to be false. This usage, which is often pejorative, arose from labeling the religious myths and beliefs of other cultures as being incorrect, but it has spread to cover non-religious beliefs as well. Because of this usage, many people take offense when the religious narratives they believe to be true are called myths. This usage is f requently confused with fiction, legend, fairy tale, folklore, fable, and urban legend, each of which has a distinct meaning in academia.If we will discuss myth further, and if we will elaborate this into details, as stated, it takes place before recorded history begins. So most likely, there is no basis or proof that it really happened in the past. And it is much easier to make a certain claim or story because nobody have experienced or witnessed such event. And the creative mind of writers/people is indeed very useful. Writers or story makers can give some scenario, a make-believe story that eventually, readers or listeners will claim as a real thing that occurs or took place somewhere else in the world somewhere back in time.How many myths and stories like this have roamed around the globe? Some where even taught in most schools and universities. And we are all quite interested in hearing or listening to such stories, because our imagination is at work. Then we begin to wonder, t o share it to others and eventually, hold to it as the truth. Now, let’s define reality. In everyday usage, it means â€Å"the state of things as they actually exist. † Reality is something that really happened or is happening. Most of the important or significant happenings are documented so it will be preserved and nobody will and can question its existence and or occurrence.Most of it nowadays are being broadcast, televised, exposed and presented to the world using communication mediums. Now, let me have my stand. Heroic acts of great men cannot be claimed as myth. It is a reality. It is in the history. How would we ever named some of them and make a story about their battles and their respective lives and contributions in the entire country if we really don’t have any basis or something to claim as their â€Å"walks† during their time? Where did historians get their stories behind the past events?How writers of different ages, races derived their resp ective write-ups and claims if they don’t have any research or basis in writing such things? We cannot say that it was merely frictional or due to their abundant and wild imaginations, though we know that human beings are highly intellectual. And a lot of discoveries around the world are eminent to all races, that would enlighten and give people the hint or idea of what happened in the past or what people in the early years have or experienced before they vanished in the surface of earth.Heroic acts are not merely the act of giving someone’s life for the sake of something bigger. It is not always the act of doing something great, it is not always visible in the naked eyes. Sometimes or there are times that silence is indeed the act itself of heroism, of course it depends on the situation. And heroism is not measured on how small or big it is, so long that action was done with love and dedication for something worthwhile. Let’s have the Philippines as a clear exa mple for this matter. We all know that there was a lot of invasion in the above mentioned country.But there were those great man who stand out and fight to get the freedom of their beloved country. To name a few, there is Jose Rizal who used his brilliant mind in writing to awaken the heart of his fellow Filipinos to fight against Spaniards, Andres Bonifacio, Lapu-Lapu, GOMBURZA (Gomez, Burgos and Zamora) and a lot more. Their acts of heroism are of different forms and ways. But still, they made a difference. In America, there are as well great heroes. To name some, there is John Ordroneauxre who fought the British in 1812; Haym Salomon who was the financier of the revolutionary war; Col.Leon Dyer who served the country in the three wars; Major Leopold Blumenberg who was a hero of the civil war and a lot more, in different fields, of different ways of showing their heroic acts for the country with arms wide-open. Furthermore, let’s have the exploration of Christopher Columbus , if he and his men do not have any single heroic acts in their lives during their time, they will never discover land for territorial expansion. We all know that exploration took place not just for days but of years.And those men spent their lives for such thing even if they don’t know if they will be successful or not. And yes they made it. October 12, 1492 is indeed a time they will never forget, the date they discovered America. From there on and up to the present, we all know that a lot of men devoted their lives for the love of country. Ups and downs come and go but still, America stands still. Now going back to the main issue of the discovery and conquest of America that was achieved through the heroic acts of men as a reality and not as a myth, let’s have the existence of Thanksgiving.If there is no single heroic act in the past, if there is no reason to be thankful, so why is that so that America have this Thanksgiving which usually celebrated on the second to the last week of November? It is not merely for thanking the Almighty God for all His blessings and guidance for the whole year round but as well as for commemorating the whole heroic acts of all individuals who in one way or another make America a successful and abundant country in most aspect, in all aspect. Nowadays, what is America? In the world, America is the powerful and strong nation. Great leaders ruled America.Even having some unexpected issues and battles, America remains standing. Untouched and undivided. How come? Merely because, there is those men with open arms who are very much willing to give their lives for the country without asking or waiting for anything in return. There is still and always those man who are very much willing to give something, small or big, special or not that would make a difference. I guess that’s all that matters. And that heroic act will always be there, until the end of time. We can never question that. It is something that sometim es heart could only understand.As to scholars of our times that question the issue of heroic act of some great men, maybe they have their own point of view. Maybe they have unsatisfied curiosity, maybe some of their questions were not clearly answered. We cannot please everybody nor to persuade them to believe in something that they really don’t believe. Maybe they need some proof. Or maybe, they just wanted historians/writers to prove their respective work a reality and not just mere a story to tell or something that will catch the whole world’s attention. People are entitled to hold on to their own opinion. Let’s just respect each other’s point of view.

Rudolf Virchow Father of Modern Pathology

Rudolf Virchow (born October 13, 1821 in Shivelbein, Kingdom of Prussia) was a German physician who made a number of strides in medicine, public health, and other fields such as archaeology. Virchow is known as the father of modern pathology—the study of disease. He advanced the theory of how cells form, particularly the idea that every cell comes from another cell. Virchow’s work helped bring more scientific rigor to medicine. Many prior theories had not been based on scientific observations and experiments. Fast Facts: Rudolf Virchow Full name: Rudolf Ludwig Carl VirchowKnown For: German physician known as the â€Å"father of pathology.†Parents’ Names: Carl Christian Siegfried Virchow, Johanna Maria Hesse.Born: October 13, 1821 in Schivelbein, Prussia.Died: September 5, 1902 in Berlin, Germany.Spouse: Rose Mayer.Children: Karl, Hans, Ernst, Adele, Marie, and Hanna Elisabeth.Interesting Fact: Virchow was an advocate for government involvement in public health, increased education, and social medicine—the idea that better social and economic conditions could improve people’s health. He stated that â€Å"physicians are the natural advocates of the poor.† Early Life and Education Rudolf Virchow was born on October 13, 1821 in Shivelbein, Kingdom of Prussia (now Ã…Å¡widwin, Poland). He was the only child of Carl Christian Siegfried Virchow, a farmer and treasurer, and Johanna Maria Hesse. At a young age, Virchow already exhibited extraordinary intellectual abilities, and his parents paid for extra lessons to advance Virchows education. Virchow attended the local elementary school at Shivelbein and was the best student in his class in high school. In 1839, Virchow was awarded a scholarship to study medicine from the Prussian Military Academy, which would prepare him to become an army physician. Virchow studied at the Friedrich-Wilhelm Institut, part of the University of Berlin. There, he worked with Johannes Mà ¼ller and Johann Schà ¶nlein, two medicine professors who exposed Virchow to experimental laboratory techniques. Print Collector/Getty Images / Getty Images Work After graduating in 1843, Virchow became an intern at a German teaching hospital in Berlin, where he learned the basics of microscopy and the theories on the causes and treatment of diseases while working with Robert Froriep, a pathologist. At the time, scientists believed that they could understand nature by working from first principles rather than concrete observations and experiments. As such, many theories were incorrect or misleading. Virchow aimed to change medicine to become more scientific, based on data gathered from the world. Virchow became a licensed doctor in 1846, traveling to Austria and Prague. In 1847, he became an instructor at the University of Berlin. Virchow had a profound impact on German medicine and taught a number of people who would later become influential scientists, including two of the four physicians who founded Johns Hopkins Hospital. Virchow also began a new journal called Archives for Pathological Anatomy and Physiology and Clinical Medicine with a colleague in 1847. The journal is now known as Virchow’s Archives and remains an influential publication in pathology. In 1848, Virchow helped evaluate typhus outbreaks in Silesia, a poor area in what is now Poland. This experience impacted Virchow and he became an advocate for government involvement in public health, increased education, and social medicine—the idea that better social and economic conditions could improve people’s health. In 1848, for example, Virchow helped establish a weekly publication called Medical Reform, which promoted social medicine and the idea that â€Å"physicians are the natural advocates of the poor.† In 1849, Virchow became the chair in pathological anatomy at the University of Wà ¼rzberg in Germany. At Wà ¼rzberg, Virchow helped establish cellular pathology—the idea that disease stems from changes in healthy cells. In 1855, he published his famous saying, omnis cellula e cellula (â€Å"Every cell comes from another cell†). Although Virchow was not the first to come up with this idea, it gathered much more recognition thanks to Virchow’s publication. In 1856, Virchow became the first director of the Pathological Institute at the University of Berlin. Alongside his research, Virchow remained active in politics, and in 1859 was elected as the city councilor of Berlin, a position he held for 42 years. As city councilor, he helped improve, among other things, Berlin’s meat inspection, water supply, and hospital systems. He was also active in Germany’s national politics, becoming a founding member of the German Progressive Party. In 1897, Virchow was recognized for 50 years of service to the University of Berlin. In 1902, Virchow jumped out of a moving tram and injured his hip. His health continued to deteriorate until his death later that year. Personal Life Virchow married Rose Mayer, the daughter of a colleague, in 1850. They had six children together: Karl, Hans, Ernst, Adele, Marie, and Hanna Elisabeth. Honors and Awards Virchow was given a number of awards during his lifetime for both his scientific and political accomplishments, including: 1861, Foreign Member, Royal Swedish Academy of Sciences1862, Member, Prussian House of Representatives1880, Member, Reichstag of the German Empire1892, Copley Medal, British Royal Society A number of medical terms have also been named after Virchow. Death Virchow died on September 5, 1902 in Berlin, Germany, due to heart failure. He was 80 years old. Legacy and Impact Virchow made a number of important advances in medicine and public health, including recognizing leukemia and describing myelin, though he is most well known for his work in cellular pathology. He also contributed to anthropology, archaeology, and other fields outside of medicine. Leukemia Virchow performed autopsies that involved looking at body tissue underneath the microscope. As a result of one of these autopsies, he identified and named the disease leukemia, which is a cancer that affects the bone marrow and blood. Zoonosis Virchow discovered that the human disease trichinosis could be traced to parasitic worms in raw or undercooked pork. This discovery, along with other research at the time, led Virchow to postulate zoonosis, a disease or infection that can be transmitted from animals to humans. Cellular pathology Virchow is most known for his work on cellular pathology—the idea that disease stems from changes in healthy cells, and that each disease only affects a certain set of cells rather than the entire organism. Cellular pathology was groundbreaking in medicine because diseases, which were previously categorized by symptoms, could be much more precisely defined and diagnosed with anatomy, resulting in more effective treatments. Sources Kearl, Megan. â€Å"Rudolf Carl Virchow (1821-1902).† The Embryo Project Encyclopedia, Arizona State University, 17 Mar. 2012, embryo.asu.edu/pages/rudolf-carl-virchow-1821-1902.Reese, David M. â€Å"Fundamentals: Rudolf Virchow and Modern Medicine.† The Western Journal of Medicine, vol. 169, no. 2, 1998, pp. 105–108.Schultz, Myron. â€Å"Rudolf Virchow.† Emerging Infectious Diseases, vol. 14, no. 9, 2008, pp. 1480–1481.Stewart, Doug. â€Å"Rudolf Virchow.† Famouscientists.org, Famous Scientists, www.famousscientists.org/rudolf-virchow/.Underwood, E. Ashworth. â€Å"Rudolf Virchow: German Scientist.† Encyclopà ¦dia Britannica, Encyclopà ¦dia Britannica, Inc., 4 May 1999, www.britannica.com/biography/Rudolf-Virchow.