The purpose of this discussion is to apply an understanding of the financing of health care in the United States to a particular patient situation.

Scenario: Widow Mary and a Broken Bone

Mary, an 85-year-old widow who lives independently in her own apartment, has surgery to fix a broken bone sustained in a fall. The surgeon recommends 6 weeks of rehab, and Mary goes from the hospital directly to a private rehabilitation center, where she lives for 6 weeks as she recovers, assisted by daily physical therapy and occupational therapy. All costs of the rehab center are paid for by Medicare and her secondary private insurance. At the end of 6 weeks, she has made significant progress, but is not walking well enough on her own to live independently. Her stay is extended for 2 weeks, and paid for by Medicare.

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She continues to make progress in physical therapy, but still not enough to live on her own. The social worker at the rehab center explains the choices:

• Mary can return home, with the assistance of a physical therapist three times per week for 4 weeks, covered by Medicare.
• Mary can stay on at the rehab center, but none of the costs will be covered by Medicare.

She opts to go home, but finds it difficult to navigate her apartment independently, and requires a full-time aide. The costs of the aide’s services are not covered by either Medicare or her secondary insurance. Three months later, Mary still cannot manage on her own, and continues to pay for aides from her own resources.

Use the scenario to address the following questions:

• Assess the sources of funds available to the patient in this case. To what extent do the financing entities limit the patient’s ability to make choices about care?
• Assess the financing alternatives available to a health care provider like the rehab center in the scenario. To what extent does a provider have the freedom to act in the best interests of the patient?
• What ways, if any, do you see possibilities for the patient to have had a better outcome in the scenario? Financing of Health Care, health and medicine homework help

Topic: Obesity in ADults

Please with the provided attachments complete the final draft of the research proposal, APA format, please follow instructions.

Overview/Description:

The final project for NSG6101 consists of the development of a novel research proposal specific to your role specialization. The project must include an intervention appropriate to nursing practice and consistent with your MSN role option. An alternative to the above includes the selection of a specialty organization to focus research proposals based on the priorities of that organization. Examples of these organizations could include (but are not limited to): Sigma Theta Tau International, American Nurses’ Foundation, Oncology Nursing Society, Association of Nurses in AIDS Care, American Psychiatric Nursing Association, American Association of Critical Care Nurses, National Association of Pediatric Nurse Associates and Practitioners, National League For Nursing, etc.

Throughout this course you have been developing various sections of the research proposal. This week you will assemble the final proposal (addressing faculty feedback). This paper is to be developed in APA format/style using the required template and not to exceed 15 pages (excluding title page/references/appendices). Research Proposal Final Draft, health and medicine homework help

Criteria:
Introduction

• Background and Significance of Problem
• Statement of the Problem and Purpose of the Study

Literature Review

• Summary of the Evidence for the Proposed Study

Research Question, Hypothesis, and Variables with Operational Definitions

Theoretical Framework

• Overview and Guiding Propositions(s) Described in Theory
• Application of Theory to Your Study’s/Project’s Focus
  

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Methodology

• Sample/Setting: Number and criteria for inclusion and description of place in which data will be collected.
• Sampling Strategy
• Research Design: Type (e.g., Quasi-Experimental), description, and rationale for selection.
• Extraneous Variables (and plan for how controlled).
• Instruments: Description, validity, and reliability estimates, which have been performed (on a pre-established measure). Include plans for testing validity and reliability of generating your own instrument(s).
• Description of the Intervention
• Data Collection Procedures
• Data Analysis Plans
  • Describe plan for data analysis for demographic variables (descriptive statistical tests).
  • Describe plan for data analysis of study variables (descriptive and inferential statistical tests).

Ethical Issues

• Describe ethical considerations and your plan to protect human rights.

Limitation of Proposed Study
Implications for Practice
References
Appendices

• Informed Consent Letter
  • ocedure section is clear, described in detail, specific, and all inclusive. Written in lay language (as documented by reading level score). Includes risks and benefits relevant to study. Address assent (if applicable). Research Proposal Final Draft, health and medicine homework help 

    Obesity in Adults

    Obesity in Adults

    Theoretical Framework

    This study will use grounded theory as the preferred theoretical framework. Grounded theory will provide representations of relationships between variables in a given situation. This framework will describe the relationship between specific variables that will be identified in the study of obesity in adults (Charmaz, 2014). It will also describe the outline the contribution, process, and results of the whole research process.  Glaser and Strauss (2009) explain grounded theory as an inductive theory in which the theory generation comes from the data.  Grounded theory was following methodological approach that relied on specific philosophy of knowledge or a specific epistemology. Currently the theory has improved (Charmaz, 2014)

    Overview and Guiding Propositions(s) Described in Theory

    The Grounded theory is an inductive methodology that involves a system for generating theory by following a systemic research model. The researcher performs rigorous research procedures that end up in the determination of a category of concepts. The conceptual categories are modeled in such a way that they have direct relation with one another, backed up by a theory. The theory explains action that has been determined to lead to successful resolution of a subject issue that concerns the researcher. It is important to note that all research is presumed to rely on data- “grounded on data” (Charmaz, 2014) Research Proposal Final Draft, health and medicine homework help

    Grounded theory requires that the researcher identifies the core variable and delimit it as the first step in the research study to avoid many conflicting, but equally justifiable interpretations for the data got in the research study. The researcher is also expected to drop his/her preconceptions and be open-minded to allow for emergence of new concepts in the study. Grounded Theory may be implemented in a manner that appears sequential, though they get to be simultaneous during the research process.

    Application of Theory to Your Study’s/Project’s Focus

    The first stage in applying Grounded Theory is preparation. The researcher has to come up with a research topic without conducting a literature review to minimize preconceptions. There should be no predetermined research problem. The second stage is data collection, where the researcher sets out to conduct interviews, and observations to get qualitative and quantitative data. Through theoretical sampling, the researcher will know what elements to pursue during data collection after conducting an initial analysis (Glaser & Strauss, 2009).

    The next stage is conducting of constant comparative analysis, where the gathered data is related to existing ideas through approaches such as substantive coding, pursuing sensitizing concepts, and looking for in vivo concepts. The analyzed concepts are then written up as a theory of ideas through memoing. The relationship between codes is presented as theoretical idea. The memos are written in a manner that creates a “stream of consciousness.” The final stage is data sorting of the conceptual memos, followed by a theoretical outline that captures the emergent theory from the research study. The sorted data is considered to be the first draft. Any subsequent writings become just a matter of polishing an improving the content.

     

    References

    Charmaz, K. (2003). Grounded theory. Qualitative psychology: A practical guide to research methods, 81-110.

    Charmaz, K. (2014). Constructing grounded theory. Sage.

    Glaser, B. G., & Strauss, A. L. (2009). The discovery of grounded theory: Strategies for qualitative research. Transaction publishers. Research Proposal Final Draft, health and medicine homework help

     

    Research Proposal Methodolog

     

    Extraneous variables

    Extraneous Variables in research refers to those variables that generally influence the association between variables which are being examined within the study. These variables in a nutshell influence the outcome of the study despite the fact that these variables are not of interest within the study. Within a given study, the extraneous variables are undesirable since they contribute to errors within the study. It is therefore important to identify the extraneous variables within the study and come up with appropriate ways to control them so as to avoid the unnecessary errors resulting from extraneous variables (Flegal et al 2012). Research must control extraneous variables as much as possible within their study since such variables are not worth within the study and as such they reduce the accuracy of the experimental research study.

    Within my study of obesity in adults, there occur some confounding variables that can add error variance within the study. An example of the extraneous variable within this study is the pre-knowledge of obesity among adults which in this case has the ability to hinder effective study of the actual causes of obesity among adults. Pre-knowledge about obesity will affect both independent dependent variables within the study since such knowledge has the ability to influence the dependent variable other than the independent variable (Keeble et al, 2016). This therefore means that we must come up with effective method of controlling the influence of extraneous variables within this study. Research Proposal Final Draft, health and medicine homework help

    In order to control the influence of pre-knowledge of obesity among the selected participants within the study, we can use randomization or simply randomly assigning participants within the study. Similarly, extraneous variables and their influence on the independent variables can be controlled through standardization of procedures and instructions within the study. This can be achieved through ensuring that in every step within the study, all study participants are treated the same way. Providing the study participants equal chances within the study will also help in controlling the extraneous variables and their influence on the dependent variables in the study. Research Proposal Final Draft, health and medicine homework help

    Instruments

    Measurement instruments refer to the assigning of numbers within the experimental observation so as to quantify a given phenomenon. In the study of obesity among adults, phenomenon such as quality of life, morbidity and efficacy are some of the theoretical constructs that can be evaluated. Measurement in this case will involve the operationalization of the aforementioned constructs in defined variables that can help in developing and application of instruments and tests so as to quantify the variables. The key indicators of the quality of research measuring instruments include the reliability and validity of the measures. Reliability in accordance to the classical test theory refers to any score obtained the researchers measuring instruments (Kimberlin & Winterstein, 2008). It is commonly known as the observed score. To reduce errors within the study it is important to validate the reliability of measurement instruments. Validity on the other hand is the extent to which instrument measurers what it is meant to measure and in this case in order to test the reliability and validity of my research instruments, the extent to which they provide better interpretation of the results will determine the effectiveness of the instruments.

    Description of the intervention

    Intervention plans towards adult obesity that this research focuses on will include intervention towards proper eating habits, lifestyle change interventions, proper focus on healthy diets, physical activities as well as combination of both strategies. Given the high prevalence of obesity and its seriousness which are associated with it, it is important to commission effective weight management services among adults from the age 18+.

    Date collection procedures

    The collection of data will involve multifaceted approaches which incorporate both primary data collection approaches including questionnaires. Both self-administered and interview administered questionnaires will be used (Keeble et al, 2016). Other primary data collection procedures will incorporate observations, focus group discussions, surveys and open ended interviews. The study will also involve collection of data through secondary procures. Research Proposal Final Draft, health and medicine homework help

    Reference

    Kimberlin, C. L., & Winterstein, A. G. (2008). Validity and reliability of measurement instruments used in research. Am J Health Syst Pharm, 65(23), 2276-84.

    Keeble, C., Baxter, P. D., Gislason-Lee, A. J., Treadgold, L. A., & Davies, A. G. (2016). Methods for the analysis of ordinal response data in medical image quality assessment. The British journal of radiology, 89(1063), 20160094.

    Flegal, K. M., Carroll, M. D., Kit, B. K., & Ogden, C. L. (2012). Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. Jama, 307(5), 491-497. Research Proposal Final Draft, health and medicine homework help

    Research Proposal: Obesity in Adults

     

    Research Proposal: Obesity in Adults

    Background and Significance of Problem

    Obesity is a disease that manifests itself in extremely high levels of body fat. This significant amount of fat is associated with numerous disease and other life-threatening health conditions. The Body Mass Index (BMI) is applied to measure an individual’s overweight or obesity tendencies. The BMI compares a person’s weight to the height and uses weight tables and measures for comparison. When a person’s BMI falls within the 85th percentile, they are diagnosed with being overweight. Those with BMIs that falls within the 95th percentiles are medically diagnosed with obesity (Ahmad, Ahmad, & Ahmad, 2010).

    All across the globe, the rate of obesity has been shown to be experiencing a significant increase. The number of individuals considered obese has reached an all-time high of 300 million (Ahmad, Ahmad, & Ahmad, 2010). Obesity is prevalent in developed countries, where it is considered to be a widespread metabolic problem experienced amongst individuals (Ball & McCargar, 2003). Gender nuances have also been observed in obesity as women are found to be more prone to contracting the condition (Batnitzky, 2008). On this note, this research paper will try and develop solutions to curb what has now become a global pandemic.

    Statement of the Problem and Purpose of the Study

    This essay attempts to address the overall problem of obesity currently being experienced in the modern world. The rising rates of obesity have become a chief source of concern. This essay will attempt to identify the various practices and lifestyle choices that make individual prone to contracting this malady. Then ways of mitigating these risks shall be determined. Obesity is not only evident amongst adults, but in children as well. Most children get the behavior that places them at risk from their parents through transference. On this note, the essay shall also attempt to identify ways through which adults who are already overweight and obese can ensure that they do not transfer harmful dieting practices and other lifestyle choices on to their children.

    The purpose of the project includes defining obesity and identifying the association it has to overweight. Additionally, the paper shall also strive to address the adverse outcomes associated with obesity, such as low-self esteem and reduced quality of life. Finally, the essay will endure to provide a list of dietary practices, exercise, and alternative lifestyle choices that would benefit both obese and overweight persons.

    Research Questions

    Several research questions need to be answered in this research paper

    -What is obesity and how is it different from overweight?

    -Which are the leading causes of diabetes?

    -What are the main risk factors associated with obesity? Research Proposal Final Draft, health and medicine homework help

    -What are the negative outcomes in health related to this condition?

    -Which are the main approaches to addressing obesity? What Lifestyle changes should be made? Are there medical solutions?

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  •  

    Hypothesis

    The essay shall also strive to investigate the validity of multiple hypotheses.

    H1-Lifestyle choices are the only causes of obesity. The author will try and study the link between obesity and the various choices people make in their lives. The article will strive to show that excessive alcohol consumption, leading a sedentary life and unhealthy diets contribute to obesity. At this point, other factors that could result in the same medical condition will also be investigated.

    H2-Adults that exercise regularly also experience overweight issues. The research essay will try and study the validity of this supposition.

    H3- Adults that consume healthy and low-energy foods are just as likely to become overweight. In this essay, the interaction between diet and obesity will be scrutinized to offer support to or refute this claim.

    All these theories shall act as the null hypotheses of this research study.

    Identifying and Defining Study Variables

    The three hypotheses make reference to numerous variables that will become the center of this study. Obesity is one of these variables. Since it is the concept under study, it will remain unchanged throughout the research. On this note, it will act as the independent variable. Other variables to be used include diet, physical exercise, and the causes of obesity. The author will investigate the effect changes in a person’s diet have on their overall weight gain. At the same time, a study will be conducted on the impact of physical exercise and leading sedentary lives have on the same. The information collected will reveal whether diet and regular exercises are risk factors or solutions to the obesity problem. The cause of obesity variable will also be analyzed by identifying the type of obesity people have and equating the affected individual. If there are people with the genetic variant, then H1 ¬will be nullified. The age will also be taken into account as a dependent variable.

    Operationalize Variables

    In this study, an individual’s diet is operationally defined as the consumption trends evident in the people under study. This means that the practice has to be continuous and that consuming a meal rich in energy on a single day does not count as unhealthy. However, eating this on a daily basis will be labeled harmful.

    Additionally, the study is conducted to reveal pertinent details about adult obesity. In this study, adults are any people that aged 20 years and above. The term physical exercise shall be operationally defined as any activities that an individual engages in to burn calories. These activities include walking, jogging, yoga, swimming, biking, and hiking, amongst others. Just like dieting, walking to work on a single day as opposed to driving or taking the train does not count as adequate physical exercise. For the purpose of this study, a sedentary life shall be used to contrast a life characterized by these physical activities.

     

    References

    Ahmad, Q., Ahmad, C., & Ahmad, S. (2010). Childhood obesity. Indian Journal of Endocrinology and Metabolism. 14(1):19-25.

    Ball, G., & McCargar, L. (2003). Childhood obesity in Canada: A review of prevalence estimates and risk factors for cardiovascular disease and type 2 diabetes. Canadian Journal of Applied Physiology. 28(1):117-40.

    Batnitzky, A. (2008). Obesity and household roles: gender and social class in Morocco. Sociology of Health and Illness. 30 (3): 445-62. Research Proposal Final Draft, health and medicine homework help

     

     

Directions:

Public and community health nursing involves working with vulnerable populations as equal partners with a focus on primary prevention and health promotion. Nurses should incorporate evidence-based nursing practices that demonstrate an awareness of ethnic identities, cultures, and socio-cultural practices of local clientele. In this assignment, you will design healthcare education for individuals, families, and communities from a vulnerable population of your choice. The objectives of this assignment are to:

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1. Research a current event in public and community health.

2. Increase your understanding of a particular area of public and community health.

3. Critically evaluate current processes that support a vulnerable population or community, and increases its ability to be healthy.

This assignment requires critical thinking to develop a reasoned, supported opinion of your target population’s vulnerabilities. You should explore your existing attitudes, thoughts, and intrinsic beliefs regarding the health issues of this population.  NRS 430 MDC Vulnerable Populations Substance Abusers Presentation