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Essay Instructions: Research on the Comparative Effectiveness of Medical Treatments: Issues and Options for an Expanded Federal Role (35 pages)
http://www.cbo.gov/ftpdocs/88xx/doc8891/12-18-ComparativeEffectiveness.pdf

For this assignment you are assessing the quality of the work in a piece of professional policy analysis that you have selected. The framework for your assessment is the ?Eightfold Path? presented by Eugene Bardach in his book, a required reading for the course.

Your paper should be organized into eight sections corresponding to Bardach?s eight steps. In each section you should assess how well the authors of the policy analysis accomplish each task. Typically, the policy analysis paper you are evaluating will not be organized explicitly into eight sections corresponding to these steps; it is your job to identify where and how well each task was (or was not) accomplished.

Below is an outline of the eight sections of the paper with some suggestions for how to approach assessing that task. Remember you are assessing, not summarizing, the policy analysis.

1. Define the problem
Is there a clear statement of what bad conditions are being addressed or what good conditions are felt to be inadequately evident? Do they include some indicator(s) of the magnitude of the problem? Are different perspectives on the nature of the problem presented? How might this task be done better?

2. Assemble some evidence
This is not about data for research; it is about finding out the scale and nature of the problem and what is already being done. It may be not be a separate section, but may be embedded in the definition of the problem.
Is there data about the scale or incidence of the problem? Is current policy described? Are there examples of ?best practice? elsewhere? Is there an indication of subgroups who suffer disproportionately from the problem? Is there a review of any literature on causes of the problem? How might this task be done better?

3. Construct the alternatives.
Are multiple options identified? Is continuing current policy one of the options considered? How creative are the authors in generating options? Was any original work done to identify new options? How might this task be done better?


4. Select the criteria
Are multiple objectives identified? Are operational and/or quantifiable indicators of the objectives identified? Do the multiple criteria reflect consideration of varying value frameworks about the problem? Are relevant criteria omitted? How might this task be done better?

5. Project the outcomes
Is there an explicit matrix of options and criteria? If not, is there a good reason for this omission? How well do the authors fill in the boxes in the matrix? How sophisticated are the techniques used for projecting outcomes? How might this task be done better?

6. Confront the trade-offs
Filling in the matrix usually reveals that there is no ?one best? option which scores highest on all criteria. Do the authors point out the tradeoffs among the options? If not, is there a good reason for this omission? How might this task be done better?

7. Decide
Is there a clear recommendation? If not, is the omission of this step justified by the context of the analytic work?

8. Tell your story
Is the analysis presented in a way that makes the issues clear and explains the reasoning behind any recommendation? Are the value judgments behind the selection of criteria and any recommendation made explicit? How might the analysis have been ?told? in a better way?


As noted on the course syllabus, this assignment should be about 1500 words, which is around 5 pages. That suggests an average of about a little more than half a page per task. Try to keep to this overall length, but you may vary the space devoted to each task depending on the points you want make.

Essay Instructions: The historical evolution of medical treatment and the role of government in delivering health care.

Answer the following two questions in APA format

1. I have always been fascinated not only by advances in medical treatment throughout recorded history but also by changes in the paradigms about what the healing arts considered “proper treatment.” (If you look at a Merck Manual from the 1950s, as I have, you would see such changes!! Bleeding and leeches were the standard “cures” for many a malady when our Republic was founded!!) From your readings, identify and briefly discuss 2 or 3 of the major developments or advances in medicine since the Moors occupied Spain (or our own Declaration of Independence, if you will.) what advances cost very little in money for their enormous impact and benefit and for advances prior to the election of John F. Kennedy as President! Just talk about on and cite the source in APA format

2. As you are aware, there is an enormous public sector devoted to regulating and delivering health services in the USA (made all the more so by recent "health reform" legislation)...despite our abhorrence of “socialized medicine.” From your research and experiences, identify 2 or 3 important (and not-so-visible but nonetheless important) agencies at the Federal level which impact how Americans receive health care services today or will obtain them under the reform law. Why are the agencies you cited significant “players” and what is their statutory mandate? In your view, how have these agencies met their missions? If you could reform any aspect of their operations, what might you propose, fiscal matters aside?

Essay Instructions: Outline for goal Statement
1. Intended Area of Study at Walden (Public Health PHD)
2.Relevant academic Preparation for doctoral study (CV included)
3. Relevant Professional Experience (CV included)
4. Capacity to work self directed at the doctoral Level
5.Long range professional and scholarly goals.

All of these must be inclided in the paper. I have pasted my cv for you to review.



Compassionate, empathetic and talented Physician Assistant with solid experience in neurology, internal medicine and family practice. Effective in providing excellent medical treatment to diverse patient populations. Skilled in working in cost-controlled environments utilizing healthcare delivery systems with limited resources. Accomplished in coordinating care with attending physicians and other members of multi-disciplinary healthcare teams. Board Certified in Internal Medicine and Surgery. Flexible in assuming additional responsibilities, working independently and as a team member.


EXPERTISE:

 Effectively provides routine and emergency professional medical care.
 Highly technical with the ability to use state-of-the-art medical and computer technology in an innovative manner.
 Demonstrated ability to work with Native Americans, Hispanic and forensic populations.
 Maintains composure in emergency and life-threatening situations.
 Dedicated to continued growth and education in field; currently pursuing additional medical training. Performs volunteer work to give back to the community.
 Recognized and management for ability to communicate well with professionals and patients.
 Ability to absorb, integrate and utilize vast amounts of scientific and theoretical information in a short period of time.


EDUCATION

M.S. in Internal Medicine, UNIVERSITY OF NEBRASKA MEDICAL COLLEGE, Omaha, NE, December 19, 2003

Masters in Forensic Sciences, NATIONAL UNIVERSITY, La Jolla, CA 2002

B.S. Physician Assistant Studies, PHILADELPHIA UNIVERSITY, Philadelphia, PA, 2000

High School Diploma, Le Lycee Francais De Los Angeles, Los Angeles, CA, 1990


CAREER HISTORY:

MAYO CLINIC HOSPITAL
Physician Assistant
(1/2003 to Present)

Provide Internal Medicine to transplant patients as well as provide specialized surgical care to transplant patients. Assist in outpatient evaluation of Pre and Post transplant patients. Provide diagnostic and therapeutic medical care in a critical care environment. Involved in Liver, Kidney, and Pancreas surgeries.

 Obtain patient history and examine patients in the critical care unit, outpatient, and inpatient.
 Formulate a diagnostic impression.
 Develop appropriate treatment plans and implement them.
 Monitor the effectiveness of treatment choices and make necessary adjustments in treatment plans.
 Coordinate specialty care for transplant patients in the outpatient setting.
 Perform minor surgical procedures.
 First and second assist in the operating room for Liver, Kidney, and Pancreas transplants.
 Provide counseling and education to meet patient needs for transplant.
 Prescribe and dispense prescription medications for patients.
 Give direction to various allied health staff.
 Provide Critical Care interventions to Post Operative Patients.

AMERISCAN
60
Clinical Consultant
(7/02 to 1/03)

Read and provide preliminary radiological results of completed full-body Siemens High Speed Imatron CT scan for a rapidly growing regional provider of CT diagnostic assessments. Trained for four weeks to operate state-of-the-art equipment that is presently available in only seven facilities in the United States.

 Query patients to obtain accurate medical history to determine appropriate scans required.
 Note all anatomic degenerative change or potential concerns for radiologist physician review.
 Studied new medium contrast for advanced MRI testing procedure that will eliminate standardized colonoscopy.
 Review results with patients and educate them as to medical terminology in reports.
 Proactively educate patients as to implication of findings and potential follow-up recommendations by radiologist.
 Utilize state-of-the-art technology innovately to identify serious medical problems that would not have been discovered using routine procedures.

SOCIETY OF ST. VINCENT DE PAUL CLINIC
Physician Assistant
(7/02 to Present)
Part-time: 8-16 hours per month, average
Salary: Pro-Bono; Volunteer position

Provide diagnostic and therapeutic medical care and services to a diverse population of indigent patients, including Native Americans, in an inner city outpatient setting.

 Provide exceptional care to a severely underserved population, fostering self-esteem and renewed interest in personal health and preventive medical treatment.
 Perform emergency life-saving procedures in cases such as cardiac arrest, respiratory arrest, massive hemorrhage, or similar emergencies, as necessary.
 Consult with attending and specialty physicians to coordinate care and make appropriate referrals.
 Interpret laboratory and x-ray results including complete blood counts, liver function tests, thyroid tests, electrolyte tests, urinalysis and plain films to define health problems and ascertain appropriate therapy and treatment.
 Notify attending physician on call or supervising physician regarding any unusual or unexpected events or problems requiring direct physician consultation.
 Practice safety, environmental, and/or infection control methods.
 Supervise and/or coordinate the activities of patient care and support staff within the clinic.
 Write progress notes on patients? charts indicating patient status and treatment procedures performed; maintain other records as required.
 Identify suspected substance abuse and refer to appropriate providers for evaluation and treatment.
 Educate patients and families as to the nature and treatment of disease and preventative measures.
 Obtain detailed history and perform physical examinations on assigned patients; assess and treat acute/chronic medical problems and provide direct patient care to a specified patient population.
 Examine, diagnose, treat, and educate Spanish-speaking patients without an interpreter.
 Prescribe appropriate pharmacological interventions.

GOBINDER CHOPRA, M.D.
Physician Assistant Internship
(1/02 to 4/02)
Full-time: 40+ hours/week
Hired to receive training in a private neurology practice, assist physician with patient care and support business development initiatives.

 Received training in neurological procedures, examinations, treatment modalities and patient care.
 Provided diagnostic and therapeutic medical care and services for patients and assisted in neurological evaluations and treatment plans.
 Treated patients with carpal tunnel syndrome, neuropathy, stroke, multiple sclerosis (MS), radiculopathy, tourettes syndrome and seizure disorders.
 Gained knowledge and experience of medical insurance coverage, procedures and coding.
 Assisted in the marketing and development of practice outreach.

FEDERAL BUREAU OF PRISONS
Federal Correction Institution

Physician Assistant, GS-603-09
(3/01 to 1/02)
Full-time: 40+ hours/week
Provided diagnostic and therapeutic medical care and services to a diverse ethnic and racial population of 1,800 male and female inmates incarcerated in the federal prison system.

 Instrumental, as PA-1, in the accreditation of the health services unit; earned time-off award for contribution to this certification process.
 Observed and examined patients, determining appropriate treatment plans. Monitored treatment choices and made necessary adjustments. Coordinated specialty care for patients, consulting with attending physicians to make referrals.
 Consulted with or referred patients to attending physician, when appropriate.
 Treated Native American prisoners for cancer, diabetes, hepatitis, high blood pressure, and assisted with preventative medicine and education.
 Evaluated trends in healthcare outcomes for internal study to determine treatment effectiveness and to remain knowledgeable of best practices.
 Achieved above satisfactory ratings on all quarterly appraisals, earning highest status in numerous categories.
 Provided professional and compassionate care while maintaining observance of all safety regulations and operational procedures in a high security environment.
 Identify current and previous substance abusers, recommending a treatment plan.
 Provided follow-up care after surgical procedures.
 Performed emergency medical care and trauma care for victims of violent crimes.
 Diagnosed and treated hypertension, hepatitis, diabetes, parasitological diseases, tropical diseases, flu, colds, and mulculoskeletal injuries. Managed chronic healthcare patients, which required repeated and frequent follow-up, in addition to routine and emergency situations.
 Performed therapeutic care procedures such as dispensing medications, minor surgeries, giving injections and vaccinations, administering oxygen, carrying out resuscitative measures in life-threatening situations, performing EKG?s, starting IV?s, and suturing.
 Recognized by management for effectively interviewing Hispanic prisons during violent incidents.
 Educated patients regarding preventative healthcare and communicated in a clear and concise manner with other healthcare and administrative professionals.

PROFESSIONAL DEVELOPMENT

 Primary Care Update, 45-hour conference, CME, Inc., February, 2002
 Pharmacology Update for Clinicians, 45 hours, July, 2001
 Trauma and Emergency Medicine, Federal Bureau of Prisons, 40 hours, July, 2001
 Preceptor for Physician Assistant Student in the Federal Bureau of Prisons, June-August, 2001
 Forensic Medical Investigation, 32 hours, November, 2000
 Lung, Colon, and Gastric Cancer: A New Approach, 4 hours, October, 2001
 Various on-line half-day conferences on lung cancer, gastric cancer, and colon cancer
 Submitted 465 hours of approved continuing education to national certification body as of February, 2002

Essay Instructions: HCM 349
Readings in Health Care Management: Assignment Guidelines
Assignment Guidelines Due Date
Health Care Management topics Course faculty must approve topics before beginning the annotated bibliography assignment. Students should provide to faculty a written topic approval request with a brief rationale for why these topics were chosen.

It is suggested that you begin these assignments by spending time in the library determining relevant topics and sufficient quality resources to meet the assignment guidelines. Then submit your topic choices to your faculty. The topics with rationale are due to me as soon as possible after the semester begins.

Annotated bibliography The following is a shortened example of an annotated bibliography provided Moore, S. J.

Brown, J., Boles, M., Mullooly, J., & Levinson, W. (2005).

Effect of clinician communication skills training on patient satisfaction: A

randomized, controlled trial. Annals of Internal Medicine, 13(22), 822-

829.

There were 69 physician, physician assistant, and nurse practitioner participants in this randomized controlled trial that sought to determine whether clinicians’ exposure to a communication skills training program increased patient satisfaction with ambulatory medical care visits. Although the participating clinicians self-reported ratings of their communication skills showed moderate improvement, there was no improvement of patient satisfactions scores. The authors suggested that a longer, more intensive and more broadly based program with ongoing feedback might be more effective.
*Refer to the HCM 349 Syllabus for additional guidelines for the completion of this assignment.


Use a stage three topical outline
with references and a reference page for each paper
The Little Brown Compact Handbook does not include references in its discussion on outlines; however, I require references as a further aid in helping you develop your final paper. Refer to section three in the Little Brown Compact Handbook (6th ed.) pp. 18-20 (Section 3 3b: Organizing your ideas: Outlines)
*Refer to this example for additional information on the completion of this assignment.
First stage outline: Develop the concepts or major components of the paper.
I. “Reaction time is related to physical fitness level” (Locke, Spirduso, & Silverman, 2004, p. 72).
Second stage outline: Develop the subtopics for each major component of the paper.
I. Reaction time is related to physical fitness level.
A. Comparison of the reaction time of physically active and inactive subjects (Locke, Spirduso, & Silverman, 2004).
B. Training effects on reaction time (Anderson, Weinstein, & Green, 2003).
C. Reaction time of those in poor physical condition: cardiovascular disease, hypertension (Locke, Spirduso, & Silverman, 2004).
Third stage outline: Add the most important references that support each subtopic (examples are shown without a complete reference page)
I. Reaction time is related to physical fitness level.
A. Comparison of the reaction time of physically active and inactive subjects.
1. Physically active individuals have faster reaction times than do sedentary individuals (Clark & Addison, 2001; Cohen, 2004, 2003; Jones, 2000, 2003; Jones & Johnson, 2004; Lloyd, 2004).
B. Training effects on reaction time.
1. Reaction time is faster after a physical training program (Black, 2002, 2003; Dougherty, 2003; Morgan & Ramirez, 2001; Ramirez, 2000; Richards, 2000, 2002).
C. Reaction time of those in poor physical condition (cardiovascular disease, hypertension (Locke, Spirduso, & Silverman, (2004, p. 72).
1. Cardiovascular-diseased patients have slower reaction time than normal individuals (Brown, 2000; Brown, Mathews, & Smith, 2002; Miller, 2002, 2003; Miller & Roe, 2001; Smith, Brown, & Rogers, 2003).


Requirements for this outline include references for each stage of your outline.

Use outline guides one, two, and three for this assignment.

(Your final submission will be a stage three outline and will include a reference page or pages).
**A persuasive paper Includes title page, an abstract, an introduction, a body, conclusion, and a reference page. *Refer to the Syllabus for information and specifics on the completion of this assignment.

**See LBCH pp. 95-114 for Understanding and using the elements of an argument.

A comparative paper Includes title page, an abstract, an introduction, a body, a conclusion, and a reference page. *Refer to the Syllabus for additional guidelines on the completion of this assignment.

Topic evaluation Provide a one-full page evaluation of the chosen topics, their enhancement of your knowledge, and recommendation if others would find the topics valuable or any research ideas. The above info is the criteria for twhat I need : annotated bibliography for both papers listed below(2)two Stage three outlines for comparative paper (Topic: sexual harrasement male vs female cases reported within a hospital or medical treatment facility), persauasive paper (The right to die). Please site all sources and a subject evaluation for both papers. I understand that this is more than one paper please bill my charge for all work and complete it in micro soft word 2003.