Heart Failure Readmission And Preventive Measures Homework Essay Sample

Introduction

Congestive heart failure (CHF) afflicts more than 5 million people in the United States (Garcia & Bradford, 2017). Advancements in health research have availed different CHF therapies. However, the incidence and prevalence of the disorder continue to trouble the healthcare system as indicated by increased hospitalizations and healthcare spending. This paper provides a review of the literature on strategies used to reduce readmission rates among patients with congestive heart failure.

Review of Literature

Garcia and Bradford (2017) suggest the use of a strategic, well-defined home telehealth in lowering the cost of treatment associated with CHF as well as hospital readmission rates. The proposed system also shortens the length of hospital stays when undergoing CHF treatment. CARDIOCOM, which is a progressive telehealth monitoring program was used to keep an eye on CHF patients over a 30-day period. The purpose of the program was to back the patients’ treatment scheme by using technology to gather data, monitor patients and assess patients’ risk.

The inception of the program led to a significant reduction in 30-day hospital readmissions since the program was introduced in 2007. In a similar study, Messina (2016) describes the execution of a home telehealth program meant to enhance communication among CHF patients, medical providers, and administrative staff to lower readmission rates for CHF patients receiving care at a hospital in Tampa, Florida. Messina (2016) noted that the telehealth system reduced hospital readmission rates by about 5%. Patients reported improved satisfaction as well as a reduction in treatment costs. A comparison of these two studies indicates that the effective management of CHF patients requires providers to consider innovative methods of providing post-hospital care.

In a separate study, Wiskar, Celi, Walley, Fruhstorpher, and Rush (2017) endorse the provision of palliative care for patients with advanced CHF. This recommendation is based on the success of palliative care in reducing hospital readmission rates in other health complications. It was noted that providing palliative care during inpatient visits reduced the odds of readmission for heart failure and other health complications during a nine-month follow-up period.

Prompt identification of a heart failure incident plays a vital role in averting readmission (Kanat & Nichols, 2017). One useful indicator of heart failure is pulmonary artery pressure, which is a more accurate reflection of volume status alterations in CHF patients than conventional techniques of weight monitoring and physical evaluation. It has also been noted that alterations in volume status manifest between one to three weeks before weigh changes or CHF symptom are evident.

Consequently, monitoring changes in volume status can help providers to anticipate and avert CHF incidents and readmissions. Kanat and Nichols (2017) tested a device known as CardioMEMS, which is a permanently implantable instrument that is capable of sensing changes in pulmonary arterial pressure. This gadget conveys pulmonary artery pressure readings from the patient’s home to a website accessible to the healthcare providers and provides substantial data to facilitate the management of CHF. Patients implanted with the device reported better health outcomes and reduced hospitalization rates (Kanat & Nichols, 2017).

Conventional methods of managing CHF incorporate diet, exercise and pharmacological interventions (Azad & Lemay, 2014). However, cases of CHF hospitalizations have been on the rise despite providers emphasizing the value of these interventions. Nevertheless, this observation does not mean that the mentioned intermediations are ineffective at lowering CHF-related hospitalizations. The reviewed studies do not mention whether or not other measures of managing CHF (such as diet, exercise, drugs) were used alongside the proposed technological interventions. It would be pertinent to develop a holistic, all-inclusive strategy to manage CHF effectively and lower the rate of CHF hospitalizations.

Conclusion

It is evident that the successful reduction of CHF readmission rates requires continuous monitoring of patients during hospitalization as well as following discharge. The use of technological advancements provides effective ways of keeping an eye on CHF patients post-discharge. Some of the tried and tested approaches include telehealth programs and implants. Therefore, there is a need to include technological methods in the conventional prevention strategies that focus on diet, exercise, and pharmacological interventions.

References

Azad, N., & Lemay, G. (2014). Management of chronic heart failure in the older population. Journal of Geriatric Cardiology: JGC, 11(4), 329-337.

Garcia, M. M., & Bradford, M. (2017). Improving CHF re-admission rates through CARDIOCOM telehealth program. Heart & Lung: The Journal of Acute and Critical Care, 46(3), 211-214.

Kanat, N., & Nichols, M. (2017). CardioMEMS for effective management of heart failure: Reducing healthcare utilization and 30-day readmissions. Heart & Lung: The Journal of Acute and Critical Care, 46(3), 213-214.

Messina, W. (2016). Decreasing congestive heart failure readmission rates within 30 days at the Tampa VA. Nursing Administration Quarterly, 40(2), 146-152.

Wiskar, K., Celi, L. A., Walley, K. R., Fruhstorpher, C., & Rush, B. (2017). Inpatient palliative care referral and 9‐month hospital readmission in patients with congestive heart failure: A linked nationwide analysis. Journal of Internal Medicine, 282(5), 445-451.

Natural Resources And Democracy In Political Economy

Introduction

Natural resources, specifically petroleum, natural gas, and minerals, have been linked to high-levels of corruption and authoritarian leadership. Bolivia, Indonesia, Belarus, and Congo among others are considered resource cursed countries (Haber and Menaldo 6). Much of political economy literature presents both theoretical and empirical arguments to understand the issue. Consequently, literature shows the existence of both resource curse and resource blessing across various countries. One major claim fronted is the resource rent, which ultimately leads to poor governance (Dunning 60).

In addition, resource exploitation itself is considered as a rent-seeking engagement that facilitates rent seeking in different sectors of the economy and restricting growth. Some scholars have used empirical evidence to demonstrate that natural resources facilitate authoritarian regimes. On the other hand, it has also been demonstrated that some resource rich nations have realized resource blessing characterized by low-levels of corruption and authoritative tendencies. These observations have puzzled scholars for years. As such, it remains clear how natural resources influence political economy and governance of countries. In this political economy essay, an attempt is made to explore this puzzle and present a balanced argument based on both theoretical, empirical, and critical assessments.

Theoretical Analysis

Political economy literature has employed various theories to explain the relationship between natural resources and forms of governance. Theories generally demonstrate that authoritarian political regimes or democratic political regimes may emanate in natural resource rich countries. In fact, Michael Ross (325) claims that political scientists have pointed out the extremely odd features of oil as a natural resource. Most researchers have shown that when income increases, governments tend to be more democratic (Ross 325). Conversely, Ross (325) points out that this rule does not apply in other cases. That is, a rise in income levels is more likely to result in dwindling democracy.

The claim that oil wealth or wealth from other natural resources often hinders progress to democracy is based on the theory of resource curse. According to the resource curse theory, minerals and oil abundance in poorly developed countries often drive unfavorable developmental outcomes demonstrated by massive corruption, poor economic outcomes, retarded economic growth, inefficient government, and substantial political violence. That is, poor countries endowed with abundant natural resources tend to experience a curse rather a blessing. The theory is based on the notion that a curse will affect countries over time (Andersen and Ross 993).

Haber and Menaldo claimed that the resource curse theory was not about change, but about levels witnessed in states. That is, variables had to be expressed in higher levels and, therefore, higher levels of depending on natural resources are generally responsible for lower levels of democracy while lower levels of dependence on natural resources in a country will ultimately lead to higher levels of democracy over time (Andersen and Ross 1004). This idea emanated from Mahdayy in 1970 when he argued that revenues from oil in the Middle East countries were directly collected as external sources of rents by governments that never accounted to the public (Haber and Menaldo 1).

Based on this notion, political scientists have developed the concept of natural resource rents and authoritarianism (Haber and Menaldo 1). It is argued that representation can only be attained through taxation without any exceptions. Further, oil revenues are collected by states, which then escalate the state bureaucracy power. Since the accrued revenues are most likely to reduce or eliminate taxation altogether, they also eliminate or reduce cases of the public subjected to taxation. As such, low levels of taxation leads to low demands for representation. Scholars point out specific examples to support the resource curse theory. Venezuela, Bolivia, and many resource-rich sub-Saharan African countries, which are poorer today than they were at independence (Dunning 34) are examples of countries that support the theory of resource curse.

Ross (332-336) highlights three theories to support the lack of democracy in oil-rich nations (these theories are mainly derived from studies done in the Middle East). The rentier effect is linked to the resource curse theory – governments spend oil revenues on social pressures to reduce accountability. The notion is based on low taxation (taxation effect), spending effect (heavy spending to reduce pressure for democracy), and group formation effect (spending to prevent the rise of independent groups that may demand for accountability). The repression effect is noted on increased spending on internal security and therefore prevents the public from democratic aspiration. Finally, modernization theory shows that if economic developments cannot produce social and cultural changes noted in urbanization, higher levels of education, and occupational specialization, then democracy is difficult to achieve (the case of Libya and Kuwait).

Some scholars have however demonstrated that the theory is flawed. For instance, Haber and Menaldo (1-26) use historical data analyzed from 1800 to demonstrate that there is no resource curse.

Conversely, the theory of resource blessing has also emerged. It appears counterintuitive to present a new narrative of resource blessing against the standard narrative of natural resource wealth as a curse for democracy and economic growth. However, current literature strives to show that natural resources can facilitate democratic processes and create stable institutions and countries. In fact, the notion that abundance of natural resource is beneficial to economic development is supported by Haber and Menaldo (1-26) and mentioned by Dunning (5) and Andersen and Ross (1003). The idea is based on nationalization of natural resources to facilitate and gauge national development. In fact, it argued that natural resources are responsible for democracy in Botswana, Mongolia, and Peru among others (Haber and Menaldo 6).

Overall, the resource curse theory and other examined theories demonstrate casual mechanisms, such as power, control, and institutions, which governments use to restrict or promote accountability while minimizing or improving democratization.

To prove such claims, researchers have conducted extensive studies using data drawn from various countries covering significant periods before, during, and even after the natural resource boom.

Empirical Analysis

Andersen and Ross (993–1021) observe that the claim by Haber and Menaldo that no resource curse exists is partially right for the period before 1970s, but flawed after 1980s because of the obvious widespread resource curse. They argue that the resource curse was witnessed after the events of the 1970s that facilitated the collection of oil rents previously looted by foreign-owned companies. The relationship between oil and democracy is vital, as well as other variables such as period, resource-reliant states, polity, incomes from resources, and fiscal reliance among others.

Based on these observations, Andersen and Ross (993–1021) show that natural resources do indeed promote autocracy. Dunning attempts to challenge the conventional claim of resource curse, but he ends up with two valid arguments that oil and mineral wealth can result in both democracy and autocracy using different mechanisms. Hence, it is imperative to comprehend these mechanisms to identify when democratic or authoritarian outcomes are comparatively strong. Statistical modeling and game-theoretic models can help to understand such relations. Ross (325-361) after analyzing time-series cross-national data from 113 states between 1971 and 1997 to explore three aspects of the oil-impedes-democracy claim concluded that oil does negatively affect democracy even in poor nations with relatively small exports. Second, harmful effects of oil on democracy go beyond the Middle East. That is, it affects all countries across the world. In addition, non-oil natural resources also have similar effects on democracy.

It is imperative to recognize that authors covered in this essay show balanced accounts of influences of natural resources on democracy. That is, they all discuss diverse aspects of resource blessings and resource curses across many countries globally to ensure that analyses are not restricted to few countries. For instance, Haber and Menaldo (1-26) address the problem of the negative association between natural resources and democracy using time-series centric techniques on unique historical datasets. The authors tested possible long-run association between regime types and resource dependence within states over periods, and they concluded that increased dependence on natural resources was not related to authoritarianism. In fact, study results indicated several aspects of resource blessing.

Critical Assessment

The four authors present incredible findings about association between democracy and natural resources in political economy. One must appreciate that all the works have both theoretical and empirical underpinnings. As such, they strive to present balanced arguments based on theories and data to draw inferences. Consequently, Ross (325-361) and Andersen and Ross (993–1021) support the resource curse theory. Conversely, a study by Haber and Menaldo (1-26) demonstrates resource blessing while Dunning attempts to go beyond resource curse and resource blessing to show that natural resources can result in both autocracy and democracy based on how they are exploited and distributed within a country. Scholars and students interested in political economy and influences of natural resources on countries, as well as democratic practices would find these works extremely useful.

One must note that the major constraints of these works could be linked to datasets used, historic periods, and other possible variables, such as institutions that could influence outcomes of the use of natural resource wealth and its effects on democracy.

These works fit well within political economy theories and build on previous studies to prove and disapprove theories of resource curse and resource blessing, but data used are original and specific to countries.

So far, in political economy of natural resources, the theories of resource curse and resource blessing have presented the best explanations for the outcomes observed. On this note, scholars require additional empirical evidence to support these theories.

Although all the works used in this essay demonstrate well-researched and presented articles, the work by Haber and Menaldo (1-26) goes against the standard narrative of resource curse to present resource blessing. Interestingly, Andersen and Ross (993–1021) show that the findings by the later were flawed. Hence, the work by Anderson and Ross introduce some variables not previously used in the study that showed resource blessing. Besides, Dunning also presents a good book by demonstrating that both democracy and autocracy are possible outcomes but through different methods while Ross only confirms the known fact of resource cursing.

Works Cited

Andersen, Jørgen J. and Michael L. Ross. “The Big Oil Change: A Closer Look at the Haber–Menaldo Analysis.” Comparative Political Studies 47.7 (2014): 993–1021. Print.

Dunning, Thad. Crude Democracy: Natural Resource Wealth and Political Regimes. Cambridge, UK: Cambridge University Press, 2008. Print.

Haber, Stephen and Victor Menaldo. “Do Natural Resources Fuel Authoritarianism? Reappraisal of the Resource Curse.” American Political Science Review (2011): 1-26. Print.

Ross, Michael L. “Does Oil Hinder Democracy?” World Politics 53 (2001): 325-361. Print.

Economic Interdependence Theory And Future Of Trade

Key Aspects of Economic Interdependence

The modern world is a complex mechanism, as it consists of numerous actors engaged in the division of labor and resource exchange. Even the countries with high political and economic influence have always experienced a need to trade 1. This matter can be explained by the economic interdependence theory, as all nations are the parts of the trading network and exchange the resources and products, which they cannot manufacture on their territories. The primary goal of the paper is to address the economic interdependence theory while discovering its critical tenets and highlighting the variables.

The economic interdependence suggests the enhancement of the economies of scale, a constant increase in the utilization of the raw materials, and decreasing marginal returns2. The overall level of economic growth (GNP) is linked to the dynamics of the economic interdependence, as the state gains can occur through trade3. The presence of GNP establishes the equilibrium in demand and supply of the nations, as the required goods are delivered to the nations in need. Nonetheless, presented aspects create the possibility for the opportunity costs, as the countries exchange the commodities4. The mentioned features are the core tenets of the theory and help determine the assumptions and the influence on the variables.

Economic Interdependence Theory: Assumptions

As was mentioned earlier, the economic interdependence theory requires the counties to engage in economic relationships. In this case, the exchange rate is one of the aspects of the economic interdependency, as the exports of one nation are dependent on the currency exchange in another country5. It defines interdependency and makes the sufficient exchange of resources a possibility. It determines the country’s GNP and assures the presence of the opportunity cost.

The political aspect has to be considered, as the impact of policies and sanctions cannot be underestimated due to its ability to be considered as a cause of limitations of the product’s exchange6. The development of a favorable political environment is essential as it defines the capabilities of the country to trade with the other nations. Lastly, the presence of peace assures the well-being of the nations and allows governmental budgeting and planning to maintain the flow of imports and exports7.

Expectations of Future Trade and Conflict

Based on the information above, the primary variables selected for the analysis are future trade expectation, which is an independent variable, and conflict (dependent variable). The presence of interdependence tends to exist due to the dependency of the GNP of the nations on the exchange and diversity of labor. In general, future trade expectations can be referred to as the development of the particular trends and expectations about the potential areas of the behavioral patterns of the nations engaged in the trading relationships8.

The conflict implies the nations have different viewpoints while determining the necessity of the distribution of the particular resources9. In this instance, the conflict is considered as a political, economic, and social phenomenon, as it has a vehement influence on the well-being of the country and causes instability in the world. In turn, it contributes to the understanding of the precise economic expectations of other actors due to the existence of the conflict’s rationale.

Variables in the Context of the Theory

The economic interdependence theory has a vehement influence on the selected variables. The expectations of future trade might be considered as a potential reason for the development of the conflict in the context of the economic interdependence theory since the lack of compliance with the anticipations might be a cause of the increased level of aggression10. In this case, the expectation of future trade is the matter, which tends to affect the growth of the conflict and define the assumption regarding the actions of other actors. In turn, the conflict is a response to the actions of the other participants of the economic exchange due to the absence of agreement in future opportunities.

Operationalization of Each Variable

Additionally, the variables are discovered in more detail. Expectations of the future trade are divided into the positive and aggressive attitudes towards the actions of the other nations while referring to the ability of the country A to fulfill the expectations of the state B. A negative attitude are determined by the lack of economic growth and rise in the development of the trade policies in the country B. As for the conflict, it will have two gradations as war and peace. On the contrary, peace will be characterized by the sufficient wellbeing of the nation and the economic enhancement. Trading relationships will be developed in a sophisticated manner while aiming at the increase in GDP and division of the resources.

Casual Logic

The interdependence of the selected variables can be described with the assistance of the graph presented in Figure 1. In this case, it remains evident that the lack of agreement with the future trade expectations can be considered as the primary reason for the conflict, as it drives the cultivation of the negative attitudes of the political leaders. In turn, it leads to the increasing necessity of the interventions in the functioning of the other countries to assure the delivery of required resources11. In turn, peace is associated with the ability of the countries to find compromises and contribute to the understanding of the substantial nature of the exchange and development of economies of scale for economic growth. The peaceful environment is the primary cause of the economic, social, and political stability and definer of the establishment of the trusting trade relationships12

Interdependence between future trade expectations (vertical axis) and Conflict (horizontal axis).
Figure 1. Interdependence between future trade expectations (vertical axis) and Conflict (horizontal axis).

Generic Hypothesis

The findings contribute that the generic hypothesis can be formulated as if state A does not comply with the expectations of state B to deliver the required resources, state B may change its attitudes to aggression, and a lack of the compromise may lead to the conflict. On the contrary, the trusting relationships and compliance with the trade expectations are core definer of the absence of conflict. Figure 2 depicts the flow of events related to the presented hypothesis.

Responsiveness of state A to the B’s requirements.
Figure 2. Responsiveness of state A to the B’s requirements.

Conclusion

The economic interdependence theory is the core component in the modern world, as it defines the division of labor and exchange of the resources. Its critical tenants affect the global economy by influencing GNP, opportunity costs, exchange rates, and division of labor. The future trade expectations affect the presence of conflict, and the development of the policies can help introduce new approaches for the optimization of exchange and the ability to find equilibrium between supply and demand.

Bibliography

Copeland, Dale. Economic Interdependence and War. Princeton: Princeton University Press, 2015.

Gartzke, Erik, Li, Quan, and Boehmer, Charles. “Investing in the Peace: Economic Interdependence and International Conflict,” International Organization 55, no. 2 (2001): 391-438.

Humphreys, Macartan. “Natural Resources, Conflict, and Conflict Resolution: Uncovering the Mechanisms,” Journal of Conflict Resolution 49, no. 4 (2005): 508-537.

Footnotes

  1. Dale Copeland, Economic Interdependence and War (Princeton: Princeton University Press, 2015), 29.
  2. Ibid, 30.
  3. Ibid, 45.
  4. Ibid, 47.
  5. Ibid, 160.
  6. Ibid, 161.
  7. Erik Gartzke, Quan Li, and Charles Boehmer, “Investing in the Peace: Economic Interdependence and International Conflict,” International Organization 55, no. 2 (2001): 391.
  8. Copeland, Economic Interdependence and War, 38-39.
  9. Macartan Humphreys, “Natural Resources, Conflict, and Conflict Resolution: Uncovering the Mechanisms,” Journal of Conflict Resolution 49, no. 4 (2005): 508.
  10. Copeland, Economic Interdependence and War, 48.
  11. Ibid, 161.
  12. Gartzke, Li, and Boehmer, “Investing in the Peace”, 399.

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