Health Literacy in the USA

Health Literacy in the USA Social Determinants of Health Constantin Vintilescu Health Literacy Predicting future trends in any profession cautions careful review of present and past trends. Over the last two decades, health care in the United States has undergone major changes due to simultaneous advances in the fields of health information and information technology. Advances in health care and life expectancy also have created dramatic changes. Subsequent gains in life expectancy have surpassed the gains achieved, between the years 1940 and 1964 with the advent of antibiotics. In fact, recent gains have exceeded that of any other time this century. The life expectancy projections for the rest of this century may turn out to be even more significant. The educations of the public about health literacy issues and the rights of the elderly have become another dimension of advancement, along with the â€Å"rights† of patients and minority groups including the physically handicapped. In the United States, the term literacy is generally defined as the ability to read and speak English (Andrus, 2002). In the 1992 National Adult Literacy Survey (NALS), the U.S. Department of Education (1993) defined literacy as: â€Å"the ability to use printed and written information to function in society, to achieve one’s goals, and to develop one’s knowledge and potential.† Although no precise point defines the difference between literacy and illiteracy, the commonly accepted working definition of what is meant to be literate is the ability to write and to read, understand, and interpret information written at the eight-grade level or above. Health literacy refers to how well an individual can read, interpret, and comprehend the health information for maintaining an optimal level of wellness. It is an essential aspect for access to health care and health-related services. Limited health literacy leads to poor health outcomes. In fact, literacy skills are â€Å"a stronger predictor of an individual’s health status than age, income, employment status, education level, and racial or ethnic group† (Weiss, 2003). Health literacy is also important for people’s maintenance of health and wellness. Health literacy is very important because requires peoples to have a more active role in health decision and their management. Based on available statistics over the past twenty years, it is evident that the United States has significant health literacy problems. Health literacy has been termed the â€Å"silent epidemic,† the â€Å"silent barrier,† the â€Å"silent disability,† and â€Å"the dirty little secret† (Conlin Schumann, 2002). In fact, the United States only ranked among the middle of other industrialized nations in most measures of adult literacy; and yet many of our educators, elected representatives, and social advocates have remained blind on this significant problem (Kogut, 2004). Over the past two decades, the literacy of the American population has been the subject of increasing interest and concern by educators as well as by government officials, employers, and the media. Health literacy continues to be a major problem in the United States despite public efforts to address the issue and developing health literacy training programs. In our society, many people do not possess the basic literacy to navigate the increasingly complex health care field. Some people have difficulty in reading and comprehending information well enough to be able to fill out job and insurance applications, tax forms, or apply for a driver’s license. In the early 1980s, President Reagan launched the National Adult Literacy Initiative, which was followed by the United Nation’s declaration of 1990 as the International Literacy year (Belton, 1991). In light of the relatively recent attention given to health literacy in the last twenty years, we must acknowledge the efforts of two organizations Literacy Volunteers of America, Inc., and Lauback Literacy International – that served for many years as advocates for the most marginalized adult populations in United States and around the globe. Of particular concern to the health care industry are the numbers of consumers who are illiterate, functionally illiterate, or marginally literate. People with poor reading and comprehension skills have disproportionately higher medical costs, increased number of hospitalizations, readmissions, and more perceived physical and psychosocial problems than do literae persons (Baker, 1998). Today the health care literacy problem has grave consequences, because patients are expected to assume responsibility for their self-care and health promotion. If people with low literacy abilities cannot fully benefit from given information, then they ca nnot be expected to maintain their health independently. Computer literacy is also an increasingly popular concern of health literacy. Many health care providers and consumers are relying on computers as educational tools. â€Å"Those clients who are well educated and career oriented are already likely to own a computer and be computer literate, but those with limited resources, literacy skills, and technological know-how are being left behind† (Zarcadoolas et al., 2006). Health care providers relied for many years on printed education brochures as a cost-effective way to communicate health instructions with people. For many years, nurses and doctors thought that written materials given to the patients were sufficient to ensure informed consent for different test or procedures. This way they promoted compliance with treatment regimens and discharge instructions. Kessels (2003) pointed out that 40-80% of medical information provided by health professionals is forgotten immediately, because not only medical terminology is too difficult to understand, but also because too much information contributes to poor recall. He also noted that half of the information remembered is incorrect. Recently the health care providers have begun to realize that if the scientific and technical terminology in education materials are not written at a level and style appropriate for their intended audiences, people cannot be expected to be able or willing to accept responsibility for self-care. In improving written health materials and in implementing health education it is important to know the literacy skills of the patients in the community and their families. Nurses play an important role in assessing patient’s literacy skills because nurses interact more with the patients and their families than the physicians do. The nurses can evaluate the ability of the healthcare client to understand printed health information by assessing the patients’ comprehension and reading skill level. There are specific guidelines for writing effective health education materials and teaching strategies for patients and their families. An individual‘s functional health literacy is likely to be significantly worse than his or her general literacy skills, because of the more complicated language used by health care providers. Now that manage care insurance companies are requiring subscribers to take more responsibility for their self-care, poor health literacy can increasingly lead to negative consequences and escalated morbidity, and mortality. People with low health literacy don’t have knowledge or are misinformed about the body and the causes of illnesses. Because they do not have the proper knowledge, they don’t understand the relationship between lifestyle factors, like diet and exercise, and wellness .Those people with limited knowledge may not know how to seek care. Health literacy tactics that improve written health materials may include: Written health materials should have plain language for better understanding and ease of sharing with people. Written health materials should be scientifically accurate and culturally appropriate. If the client does not fluently speaks English, provide the written health information in his/hers native language. If such information is unavailable, and a translator must be employed, it is critical to assess the client’s understanding of the written material. Written health information should include pictures for better understanding. Personal electronic devices such as cell phones, tablets, palm pilots, and talking kiosks can be a new method for sending health information to the patients. Before health providers make a health education brochure, they should also consider alternate methods such as individual, group, organizational, community and mass media. Use a short brochure that presents â€Å"bottom line† information, systematic instructions, and uses pictures with visual cues that highlight most important information to be absorbed. Health brochures should align health information with recommendations to services, resources, and other available support. Removing the barrier to communication between individuals and health care providers is a good opportunity for nurses to function as facilitators and work in collaboration with other health care professionals for improvement of quality of care. As Advanced Practice Nurses, it is our mandated responsibility to teach in non-complicated terms so our patients can understand an fully benefit from our nursing interventions. References Andrus, M.R., Roth, M.T. (2002). Health literacy: A review. Pharmacotherapy, 22(3), 282- 302. Baker, D. W., Parker,R. M., Williams , M. V, Clark , W. S. (1998). Health literacy and the risk of hospital admission. Journal of Internal Medicine, 13, 791-798. Belton, A. B. (1991).Reading levels of patients in a general hospital. Beta Release, 15 (1), 21-24.California HealthCare Foundation. 2005. Consumers in Health Care: The Burden of Choice. Available at http://www.chcf.org Conlin, K. K., Schumann, L. (2002). Literacy in the health care system: A study on open heart surgery patients. Journal of the American Academy of Nurse Practitioners, 14 (1), 38-42. Institute of Medicine. 2004. Health Literacy: A Prescription to End Confusion. National Academies Press: Washington, DC. Kessels, R.P.C. (2003). Patients’ memory for medical information. Journal of the Royal Society of Medicine, 96,219-22. Kogut, B.(2004).Why adult literacy matters. Pbi Kappa Pbi Forum, 26-28. U.S. Department of Health and Human Services. Making Health Communication Programs Work. National Cancer Institute: Washington, DC. U.S. Department of Health and Human Services. 2003. Communicating Health: Priorities and Strategies for Progress. Washington, DC. Weiss, B. D. (2003). Health literacy: A manual for clinicians. Chicago: American Medical Association and American Medical Association Foundation. Zarcadoolas. C., Pleasant, A. F., Greer, D. J. (2006). Advancing health literacy: A framework for understanding and action. San Francisco: Jossey Bass.

Learning Theory of Career Counseling Essay

The original theory (Krumboltz et al, 1976, Mitchell & Krumboltz, 1990), known as Career decision making social learning theory has recently been improved to the learning theory of career counseling (Krumboltz and Mitchell, 1996). The latest version tries to combine realistic ideas, research, and procedures to offer one hypothesis that goes beyond an explanation of why individuals hunt for various jobs. Most recently, Krumboltz developed and integrated thoughts about the function of chance when it comes to career decision making. Synopsis of the development of this theory is given below. At the heart of Krumboltz’s thinking is Bandura’s Social Learning Theory (SLT). Bandura identified a total of three types of learning experiences which include: The Instrumental learning experience This results from direct experience when an individual is positively reinforced or punished for some behavior and its associated cognitive skills Associative learning experience Results from direct experience together with reinforcement when an individual associates some previously affectively neutral event or stimulus with an emotionally laden stimulus. The Vicarious learning experience Here is where people learn new behaviors plus skills through observing behaviors of other individuals or even through the media. 1)  Ã‚  Ã‚  Ã‚  Ã‚   SOCIAL LEARNING THEORY OF CAREER DECISION-MAKING (SLTCDM) This particular theory aims at informing clients career decision making options at the same time utilize the triadic reciprocal interaction concept. The role of instruments and associative learning is also emphasized. The practitioner’s tools are therefore reinforcement and modeling. The application of this theory to practice involves the practitioner’s effort to categorize and correct any wrong beliefs held by the client regarding th process of decision making. It was developed to answer the following questions: why people enter particular educational course or jobs; why they may modify course at some stage in their lives; Why individuals may show various desires for different activities during different points in their livelihood. The following are identified as influential in these processes 1.1 Influential factors: Krumboltz examines the impact of four different groups of factors: 1. Genetic Endowment and Special Abilities race gender Physical looks and traits People differ both in their capacity to gain from learning experiences and to get access to various learning experiences as a result of such types of hereditary qualities. 2. Environmental Conditions and Events Social, cultural & political Economic forces Natural forces & resources. They are normally out of every person’s control. Their influence can be planned or unplanned. 3. Learning Experiences Each individual has a unique history of learning experiences that results choice of profession. They often don’t recall the specific trait or series of these learning experiences, but they also recall those general conclusions from them (e.g. I love animals/working with children). The two main kinds of learning experiences as mentioned in this theory are: Instrumental learning experience It consists of: Preceding circumstances/stimulus; Behavioral responses (overt & covert); Consequences. Associative learning experience This is where individuals perceive an association involving two or more sets of stimuli in the surrounding. However, this in most cases could result to occupational stereotypes. 4. Task Approach Skills Interactions with learning experiences, hereditary characteristics, and finally ecological influence result in the improvement of task approach skills. These include: personal standards of performance; work habits; Emotional reactions Formerly acquired task approach skills applied to a new undertaking or problem both influence the outcome of that task or hitch may they themselves be modified. 1.2 Resulting cognitions, beliefs, skills & actions: As a result of the complex interaction of these four types of influencing factors (i.e. genetic endowment, environment, learning and task approach skills), people form generalizations (beliefs) which represent their own reality. These beliefs about them plus the world of work influence their method of approach towards learning new skills and finally affect their ambitions as well as their actions.   . The SLTCDM refers to people’s beliefs about themselves as either: Observation of the Generalizations: An overt or covert statement evaluating ones own performance or assessing one’s own benefit and principles. Involves a constant assessment of our own performance; View of the World Generalizations: Observations about our environment which is used to forecast what will happen in the future and in other surrounding (e.g. the caring professions). 1.2 Resulting cognitions, beliefs, skills & actions: As a result of the complex interaction of these four types of influencing factors (i.e. genetic endowment, environment, learning and task approach skills), people form generalizations (beliefs) which represent their own reality. These beliefs about them plus the world of work influence their method of approach towards learning new skills and finally affect their ambitions as well as their actions. The SLTCDM refers to people’s beliefs about themselves as either:

The History Behind the Invention of Gas Masks

Inventions that aid and protect the ability to breathe in the presence of gas, smoke or other poisonous fumes were being made before the first use of modern chemical weapons. Modern chemical warfare began on April 22, 1915, when German soldiers first used chlorine gas to attack the French in Ypres. But long before 1915, miners, firemen and underwater divers all had a need for helmets that could provide breathable air. Early prototypes for gas masks were developed to meet those needs. Early Fire Fighting and Diving Masks In 1823, brothers  John and Charles Deane patented a smoke protecting apparatus for firemen that was later modified for underwater divers. In 1819, Augustus Siebe marketed an early diving suit. Siebes suit included a helmet in which air was pumped via a tube to the helmet and spent air escaped from another tube. The inventor founded Siebe, Gorman, and Co to develop and manufacture respirators for a variety of purposes and was later instrumental in developing defense respirators. In 1849, Lewis P. Haslett patented an Inhaler or Lung Protector, the first U.S. patent (#6529) issued for an air purifying respirator. Hasletts device filtered dust from the air. In 1854, Scottish chemist John Stenhouse invented a simple mask that used charcoal to filter noxious gasses. In 1860, Frenchmen, Benoit Rouquayrol, and Auguste Denayrouze invented the Rà ©sevoir-Rà ©gulateur, which was intended for use in rescuing miners in flooded mines. The Rà ©sevoir-Rà ©gulateur could be used underwater. The device was made up of a nose clip and a mouthpiece attached to an air tank that the rescue worker carried on his back. In 1871, British physicist John Tyndall invented a firemans respirator that filtered air against smoke and gas. In 1874, British inventor  Samuel Barton patented a device that permitted respiration in places where the atmosphere is charged with noxious gasses, or vapors, smoke, or other impurities, according to U.S. patent #148868. Garrett Morgan American  Garrett Morgan patented the Morgan safety hood and smoke protector in 1914. Two years later, Morgan made national news when his gas mask was used to rescue 32 men trapped during an explosion in an underground tunnel 250 feet beneath Lake Erie. The publicity led to the sale of the safety hood to firehouses across the United States. Some historians cite the Morgan design as the basis for early U.S. army gas masks used during WWI. Early air filters include simple devices such as a soaked handkerchief held over the nose and mouth. Those devices evolved into various hoods worn over the head and soaked with protective chemicals. Goggles for the eyes and later filters drums were added. Carbon Monoxide Respirator The British built a carbon monoxide respirator for use during WWI  in 1915, before the first use of chemical gas weapons. It was then discovered that unexploded enemy shells gave off high enough levels of carbon monoxide to kill soldiers in the trenches, foxholes and other contained environments. This is similar to the dangers of the exhaust from a car with its engine turned on in an enclosed garage. Cluny Macpherson Canadian  Cluny Macpherson designed a fabric smoke helmet with a single exhaling tube that came with chemical sorbents to defeat the airborne chlorine used in the gas attacks. Macphersons designs were used and modified by allied forces and are considered the first to be used to protect against chemical weapons. British Small Box Respirator In 1916, the Germans added larger air filter drums containing gas neutralizing chemicals to their respirators. The allies soon added filter drums to their respirators as well. One of the most notable gas masks used during WWI was the British Small Box Respirator or SBR designed in 1916. The SBR was probably the most reliable and heavily used gas masks used during WWI.

Shakespeares Romeo and Juliet Essay - 737 Words

Romeo and Juliet, is one of the famous plays written by William Shakespeare who is known for his famous plays and poems. Romeo and Juliet are repeated by two different directors which are not alike, in both directing and speaking. The play is a very tragic at the end when Romeo and Juliet die due with their parent’s strife and hatred; however their death ends the anger and rage between the two families. The main theme of the play is romantic but ends with a tragic scene because the two star crossed lovers take their life to a whole misadventured piteous overthrows their parent’s strife. Act 3 is when the feud happens between tybalt and Mercutio, it starts off on a hot day in a public place, Mercutio and Benvolio walking and unexpectedly†¦show more content†¦Act 3 scene 1 begins in a public location, it starts off on a hot day with Mercutio and benvolio walking and benvolio tries to tell Mercutio to rest because of the heat which makes people furious and angry s o he doesnt want to start trouble. But Mercutio doesnt care, he makes himself look strong and skilful, Mercutio is the one looking for trouble that’s when the Capulet’s arrive in scene 2 tybalt and his group enters the scene than tybalt asks if he could have a word with one of them. The opening of scene 2 is build excitement for the audience, they know tybalt is looking for revenge on Romeo for gate crashing the party and thinks he came to insult them, Mercutio takes no interest in him and makes a fool out of tybalt than tybalt got to a point to insult him by saying his sexual attracted to Romeo and the reader or viewer knows that Mercutio is high tempered so he gets furious and mad. But Romeo arrives in the scene 3, the reader or viewer already knows Romeo got married with Juliet which is Tybalt’s cousin so he cant fight with a member of his family, Romeo shares love and kindness with tybalt but tybalt is not thinking correctly and has a negative feeling toward s tybalt because his full of hatred and rage that he wants to kill Romeo. Episode 4 is an episodicShow MoreRelatedShakespeares Romeo and Juliet1499 Words   |  6 PagesEnglish class are struggling to pay attention. 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Shakespeare built up the tension to Scene 5 from the start of Act 1 intelligently by, for example, building up the feud between the families. This build up of tension is essential to the context of the story and without this the play would not be as dramatically effective. Right from the very start, the feud betweenRead MoreShakespeares Romeo and Juliet Essay672 Words   |  3 Pagesplay, Romeo and Juliet, by William Shakespeare, Romeo and Juliet are portrayed as star-crossed lovers. In the opening scene, the chorus states that Romeo and Juliet are two young lovers from opposing families who were destined to fall in love and eventually die together. Juliet’s parents have the perfect life planned for Juliet. She has the perfect fiancà ©, she was going to have a great family, and live happily until the day she died. But then it was love at first sight for Romeo and Juliet. 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The tragic death has many characters to blame, but it is impossible to pinpoint the full responsibility on one individual character. Many of the characters in Romeo and Juliet blame each other, for example, the Prince blames the two families and feud for