The criminal justice system’s role in rehabilitating law violators is quite immense. As the system is designed to enforce existing laws in society and ensure effective rehabilitation of criminals, there arises a dire need to implement efficient strategies that will prevent the future recidivism of criminals by completely transforming the inmates into socially acceptable individuals. Among the most effective methods is offering prison education by tutoring college programs. The practical implementation of educational programs that offer college courses is an essential societal tool with benefits that surpass the original intention of rehabilitating criminals. The benefits of prison education are impactful on individuals, society, and the criminal justice system. Though the efforts to offer college programs to inmates in prisons may face a few stumbling blocks, such as lack of necessary tools as well as unethical behaviour of some inmates, it is an essential tool that positively impacts the inmates’ rehabilitation efforts, the economy as well as the society in general.
Benefits to the Individuals
Offering college programs is the best approach to ensure that the rehabilitation system benefits the inmates. Education is also a fundamental right that is much deserved by the inmates with the power to develop new skills as individuals, thus increasing their chances of being professionally waged once they are out of prison (Cormac 9). Additionally, adult education in prisons is considered an integral part of the efforts to boost the reintegration of the inmates’ learners into society and boost their employment chances (Northwestern University). Educating the prisoners efficiently prepares them for further studies once released from their penal sanctions, guaranteeing them a much more opulent life. Additionally, the prisoners who embrace training are much more able to rebuild the broken bonds when incarcerated. Additionally, considering the negative insights concerning inmates, offering education programs is essential in reconceptualizing education as a form of citizenship and creating a new positive identity of prisoners as students and citizens rather than convicts (Cormac 83).
Benefits the Society
The positive impact of total rehabilitation of prisoners in society is quite far-reaching. Though research indicates that the recidivism rate is at 67.8% as previously incarcerated persons are rearrested within three years, education programs thus become essential for reducing these inmates’ recidivism when reintegrating into society (Northwestern University). As evident, inmates who embrace the education programs are less re-incarcerated. Furthermore, the higher the level of education the prisoners receive, the lower the chances of recidivism (Northwestern University). The intergenerational cycle of injustice and incarceration may be broken, as studies, for instance, show that postsecondary prison education has many positive consequences on imprisoned children (Northwestern University).
Benefits to the Economy
Society is set to benefit significantly through the education programs offered to those incarcerated, so the general economy also benefits substantially. Research indicates that offering education programs to inmates is a cost-effective investment. Investing US $ 1 million in the incarceration system could potentially reduce 350 crimes, compared to reducing 600 crimes if the same amount was injected into the prison education system (Northwestern University). Additionally, investing in educational programs for those incarcerated will save a significant amount of taxpayers through the reincarceration of persons as the cases of recidivism are reduced through prison education (Northwestern University).
As the criminal justice system endeavours to rehabilitate the delinquents of society, there arises a dire need to ensure that these individuals are successfully reintegrated into society without future recidivism. Offering college programs to inmates is an effective tool towards correcting incarcerated individuals by equipping them with the necessary skills to make them viable for professional employment once they are out of prison. Additionally, education will facilitate a smooth entry into the societal structures and enhance the rebuilding of broken bonds when the person is incarcerated. As incarcerated individuals and society gain from the education offered to them in prisons, the economy also gains as these programs turn out to be cost-effective by reducing future expenses of recidivism as well as saving taxpayers’ revenue. Thus, though implementing educational programs in prisons may face a few stumbling blocks, they should indeed be a priority towards rehabilitating lawbreakers into socially acceptable persons.
Behan, Cormac. “Education in Prison: A Literature Review.” UNESCO Institute for Lifelong Learning 2021.
Northwestern University. “Benefits of prison education – Northwestern prison education program.” Northwestern University, 2022, sites.northwestern.edu/npep/benefits-of-prison-education/.
Impacts Of Diabetes On Health Care Quality, Cost, And Patient Safety Sample Paper
Health Care Quality
Healthcare quality is how healthcare services improve patient outcomes (Selvin et al., 2021). Patients diagnosed with diabetes require high healthcare quality to prevent diabetes progression. Patients also require prevention-focused treatment to reduce the risk of cardiovascular diseases and death (Selvin et al., 2021). The goals of diabetes treatment include achieving hemoglobin A1c (HbA1c) levels, controlling blood pressure (BP), and low-density lipoprotein cholesterol (LDL-C) level treatment targets (Kazemian et al., 2019). Healthcare providers emphasize beneficial interactions and care coordination among patients diagnosed with diabetes, interdisciplinary team members (nurse, dietitian, psychotherapist, physiotherapist, diabetes educator), and the community. The rationale is that care coordination promotes high-quality care and a continuum of patient management.
According to Selvin et al. (2021), the degree of population health services increases the likelihood of desired patient outcomes. However, racial minorities and low-income populations in the United States experience disproportionate health care services. This population has limited access to quality diabetes care, thus resulting in poor health-related quality of life (Selvin et al., 2021). For instance, racial minorities are less likely to receive A1c testing and diabetes and retinopathy screening services than whites. According to Selvin et al. (2021), these racial disparities persist in populations with equal access to healthcare services. Individuals with low income also have limited access to nutritious food. Minority populations (African Americans) have poor glycemic, lipids, and blood pressure control and a high disease burden. Additionally, the population has low utilization of eye and foot examination services. These disparities indicate a significant gap in healthcare quality among United States residents diagnosed with diabetes.
The measures of diabetes healthcare quality include reported patient satisfaction, eye and foot examination rates, rate of albuminuria test, and level of glycemic control (Selvin et al., 2021). These measures indicate significant progress in improving diabetes care (Ba-Essa et al., 2018). It is essential to monitor trends in diabetes quality indicators. The rationale is that monitoring quality measures help evaluate the effectiveness of implemented interventions and identify gaps in care that impair population health outcomes.
Patient satisfaction is expressed as hospital waiting time and the effectiveness of technology used during healthcare interaction and patient evaluation (Selvin et al., 2021). Advanced technology, such as telehealth, enables patients to receive high-quality and timely healthcare services. Remote patient monitoring also improves healthcare utilization. Telehealth promotes remote patient monitoring, which involves digital tracking of patient data on glycemic levels, thus improving patient management by reducing unnecessary hospital visits (Lee et al., 2018). These aspects improve healthcare quality and patient satisfaction. In addition, advanced technology has decreased the proportion of underdiagnosed cases of diabetes and delayed treatment initiation over the past 20 years (Selvin et al., 2021). High healthcare quality and early treatment promote more prolonged patient survival and high health-related quality of life.
Patient safety focuses on reducing the risk of harm by promoting high-quality care and preventive interventions (Selvin et al., 2021). Patients diagnosed with diabetes have a high risk for cardiovascular complications, renal and hepatic complications, lower limb amputation, and vision loss (Reed et al., 2021). Therefore, delayed treatment and poor management of diabetes symptoms increase the risk of terminal diseases and premature death. Patients diagnosed with diabetes have minimal safety due to immune dysfunction. This population is prone to infection and prolonged healing, especially of wounds (Reed et al., 2021). Additionally, this population is susceptible to depression due to poor coping skills and increased distress. Therefore, healthcare providers should focus not only on diabetes care but also on psychological support.
According to Selvin et al. (2021), the availability of new medications and changes in clinical recommendations improve risk factor control, thus improving patient safety. Elderly patients diagnosed with diabetes have high morbidity and impaired cognition. Additionally, the elderly population has pervasive polypharmacy. These aspects complicate the treatment and management of diabetes (Selvin et al., 2021). Therefore, the patients experience a high disease burden and mostly die due to diabetes-associated heart attacks and hypertension. Therefore, caregivers should coordinate patient care to improve patient outcomes and life expectancy and protect elderly patients from harm and infections. Caregivers can also increase patient education and training to empower patients in self-care practices (Dhatariya et al., 2020). Patient education improves health literacy and promotes self-management.
Diabetes is a significant public health burden in the United States. Patients diagnosed with diabetes require medication and psychotherapy. The patients incur high healthcare costs attributed to continuous insulin therapy, regular screening, hospitalization, and hospital visits. These patient needs account for direct healthcare costs, which can deter patients from seeking healthcare services due to low income (Riddle & Herman, 2018). The indirect cost of diabetes care includes reduced productivity, early retirement, work absence, and loss of employment due to disability. Disability-adjusted lives and early retirement deplete labor, thus affecting the economy and growth (Riddle & Herman, 2018). Patients also incur the cost of preventive interventions such as nutritional, physical fitness, and hospital travel costs. These high-cost result in the economic barrier of medication utilization. According to Kazemian et al. (2019), diabetes prevalence is expected to increase to 54 million by 2030. This prediction indicates that the healthcare cost of diabetes management will increase dramatically.
The American Diabetes Association (ADA) reports an increasing trend in healthcare costs associated with diabetes care. The total direct cost of diabetes care in the U.S. was $116 billion in 2007, $176 billion in 2012, and $237 billion in 2017 (Riddle & Herman, 2018). The increasing cost of healthcare is attributed to the increasing prevalence of diabetes, insulin expenditure, and medication supply. Healthcare for one person costs $16,752 annually (2.3 times the average expenditure of a person without diabetes) (Brown et al., 2018). Approximately 1 in every four healthcare dollars is spent on diabetes management in the U.S (Riddle & Herman, 2018). This evidence instigates the implementation of safe, efficient, and cost-effective treatment plans such as lifestyle interventions.
Caregivers can improve access to diabetes care by targeting the highly prevalent populations to reduce hospitalization and other healthcare costs. Most importantly, public health nurses can focus on community programs that educate people about healthy lifestyles, healthy diets, and the health consequences of diabetes (Riddle & Herman et al., 2018). Creating public awareness can help people adhere to diabetes prevention recommendations.
Effect of State Board Nursing Practice Standards and Governmental Policies on the Impact of Diabetes on Quality of Care, Patient Safety and Costs
The State Board Nursing Practice Standards focus on nurse qualifications. State boards of nursing require nurses to meet professional qualifications, skills, and knowledge for authorization to practice nursing. The Board of Nursing protects the integrity of the nursing profession and the quality of healthcare delivery (Beck et al., 2017). Qualified nurses are granted practicing licenses and must adhere to the nursing code of ethics by protecting patients from harm, maleficence, and injustice. According to Lawler et al. (2019), qualified nurses provide high-quality diabetes care and coordinate patient care to improve patient outcomes, patient experience, and satisfaction. Quality healthcare also reduces patient length of stay in the hospital, readmission, unnecessary hospital visits, and patient harm and diabetes-related complications. Therefore, recruiting qualified nurses is cost-effective and improves healthcare quality.
One governmental policy that influences the impact of diabetes on patient safety, healthcare quality, and the cost is the Affordable Care Act (ACA). ACA improves the affordability of healthcare services among vulnerable populations. This policy has increased the number of insured Americans by expanding Medicaid, providing a subsidized health insurance marketplace, and decreasing insurance disparity for populations affected with chronic diseases such as diabetes. According to Riddle & Herman (2018), ACA increased the health coverage of adults younger than 65 diagnosed with diabetes from 84.7 to 90.1% (Riddle & Herman, 2018). Additionally, many families with low income and less than a high school education had health insurance coverage. This data shows that the ACA reduced healthcare costs and improved healthcare quality and access. ACA covers type 2 diabetes screening, diet counseling, and psychotherapy expenses (Brown et al., 2018). Therefore, patients have reduced out-of-pocket expenditure, high medication use, and diabetes management.
The Americans with Disabilities Act (ADA) policy influences patient safety by protecting patients from discrimination in workplaces, schools, healthcare facilities, and living environments (American Diabetes Association, 2022). This policy recognizes patients diagnosed with diabetes as disabled individuals that require quality care and physical and social support. These policies improve patient safety, healthcare quality, and cost-effectiveness of diabetes healthcare.
The state board of nursing standards and the governmental policies guide nurses’ actions in promoting health care quality, patient safety, and costs. Nursing standards provide insights into protecting patients from harm and discrimination. The standards also guide nurses in making informed and ethical clinical decisions for patient beneficence. The governmental policies require nurses to enforce the laws at the local level and improve healthcare access. I gained insights into conducting public health promotion and patient advocacy to improve the utilization of diabetes care. I plan to provide high-quality, evidence-based care and collaborate with interdisciplinary team members to monitor patients and implement patient-tailored diabetes care plans.
Effects of Local, State, and Federal Policies on Nursing
Scope of Practice
Local, state and federal policies limit the nursing scope of practice. These policies restrict nurses from providing only the healthcare services they are qualified and authorized to provide (Schumer et al., 2020). For instance, endocrinologists diagnose patients with diabetes, and nurse educators educate patients diagnosed with diabetes about self-care practices and the management of diabetes symptoms. Similarly, dietitians educate patients bout healthy diets and develop meal plans, while psychotherapists help patients cope with distress. Generally, nurses can prescribe patient medication and monitor health progress. The scope of practice policies aims to protect patients from sub-standard care, which compromises patient safety resulting in poor patient outcomes and high healthcare costs.
Strategies to Improve Healthcare Quality, Patient Safety, and Reduce Costs
Strategies that can improve healthcare quality, patient safety and reduce diabetes care cost focus on preventing the exacerbation of diabetes, reducing risk factors for diabetes-related complications, and addressing barriers that deter patients from accessing diabetes care (Reed et al., 2021). These strategies include encouraging lifestyle changes, providing patient education, promoting diabetes screening, and adopting telehealth. Public health nurses can conduct community outreach programs to create public awareness about lifestyle changes, risk factors of diabetes, and the importance of physical exercise and healthy diets (Reed et al., 2021). Nurse dietitians can also educate patients diagnosed with diabetes about self-care practices, coping skills, and self-glucose monitoring. Promoting diabetes screening improves early diagnosis and initiation of diabetes care.
Patient education enables patients to make informed decisions and provides insights into patient engagement in care coordination (Powers et al., 2020). Nurses can reduce risk factors for diabetes-related complications such as cardiovascular diseases, obesity, hyperlipidemia, stroke, and heart attack by emphasizing physical activity, Mediterranean diets, and insulin and pharmacotherapy adherence. The telehealth approach can help patients overcome healthcare barriers such as transportation costs. According to Lee et al. (2018), telehealth supports timely care and readily available patient consultation, and remote monitoring of blood glucose levels. These strategies can improve healthcare quality, access, and utilization, thus promoting patient safety and health outcomes and reducing healthcare costs. The American Diabetes Association (2021) provides evidence supporting the implementation of these interventions to improve diabetes care outcomes. This resource emphasizes the provision of quality healthcare services based on standards of care.
American Diabetes Association. (2021). Standards of Medical Care in Diabetes- 2021. Diabetes Care, 44, S1-S232. doi.org/10.2337/dc21-Sint
American Diabetes Association. (2022). Is Diabetes a Disability? https://diabetes.org/tools-support/know-your- rights/discrimination/is-diabetes-a-disability
Ba-Essa, E. M., Abdulrhman, S., Karkar, M., Alsehati, B., Alahmad, S., Aljobran, A., … & Alhawaj, A. (2018). Closing gaps in diabetes care: From evidence to practice. Saudi journal of medicine & medical sciences, 6(2), 68. doi.org/10.4103/sjmms.sjmms_86_17
Beck, J., Greenwood, D. A., Blanton, L., Bollinger, S. T., Butcher, M. K., Condon, J. E., … & Wang, J. (2017). 2017 National standards for diabetes self-management education and support. Diabetes Care, 40(10), 1409–1419. doi.org/10.1177/0145721719897952
Brown, D. S., & Delavar, A. (2018). The Affordable Care Act and insurance coverage for persons with diabetes in the United States. Journal of hospital management and health policy, 2. Doi: 10.21037/jhmhp.2018.04.07
Dhatariya, K., Mustafa, O. G., & Rayman, G. (2020). Safe care for people with diabetes in hospital. Clinical Medicine (London, England), 20(1), 21–27. https://doi.org/10.7861/clinmed.2019-0255
Kazemian, P., Shebl, F. M., McCann, N., Walensky, R. P., & Wexler, D. J. (2019). Evaluation of the cascade of diabetes care in the United States, 2005-2016. JAMA internal medicine, 179(10), 1376–1385. doi:10.1001/jamainternmed.2019.2396
Lawler, J., Trevett, P., Elliot, C., & Leary, A. (2019). Does the Diabetes Specialist Nursing workforce impact the experiences and outcomes of people with diabetes? A hermeneutic review of the evidence. Human Resources for Health, 17(1), 65. https://doi.org/10.1186/s12960-019-0401-5
Lee, P. A., Greenfield, G., & Pappas, Y. (2018). The impact of telehealth remote patient monitoring on glycemic control in type 2 diabetes: A systematic review and meta-analysis of systematic reviews of randomized controlled trials. BMC health services research, 18(1), 1–10. doi.org/10.1186/s12913-018-3274-8
Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl, A., … & Uelmen, S. (2020). Diabetes self-management education and support in adults with type 2 diabetes: a consensus report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. Diabetes Care, 43(7), 1636-1649. doi.org/10.2337/dci20-0023
Reed, J., Bain, S., & Kanamarlapudi, V. (2021). A Review of Current Trends with Type 2 Diabetes Epidemiology, Aetiology, Pathogenesis, Treatments, and Future Perspectives. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 14, 3567–3602. https://doi.org/10.2147/DMSO.S319895
Riddle, M. C. & Herman, W. H. (2018). The cost of diabetes care—the elephant in the room. Diabetes Care, 41(5), 929–932. doi.org/10.2337/dci18-0012
Selvin, E., Narayan, K. V., & Huang, E. S. (2021). Quality of care in people with diabetes. https://www.ncbi.nlm.nih.gov/books/NBK568015/
Schumer, R. A., Guetschow, B. L., Ripoli, M. V., Phisitkul, P., Gardner, S. E., & Femino, J. E. (2020). Preliminary experience with conservative sharp wound debridement by nurses in the outpatient management of diabetic foot ulcers: Safety, efficacy, and economic analysis. The Lowa Orthopedic Journal, 40(1), 43–47. PMCID: PMC7368523
Imperialism And Revolution In Iran University Essay Example
A person’s life is shaped by historical forces outside the intimate spheres of family, friends, and community. Whether we are aware of it or not, the circumstances of our lives are shaped in fundamental ways by political events like elections and revolutions; by social or demographic changes, such as epidemics or population changes; by technological changes, such as improvements in health care or communications technologies; by economic developments like recessions, industrialization, and trade; by global developments like imperialism and war; and by new ideas, such those expressed during the Enlightenment. The lives of Marjane Satrapi and her family, too, were shaped by these kinds of forces, which were precisely the European read British imperialism and the revolution orchestrated by the Muslim fundamentalists.
If British imperialism had not happened in Iran, perhaps Marjane would have been raised in royalty. Marjane discovers that the emperor the Shah family had overthrown had actually been her great-grandfather. Her father tells her, “The emperor that was overthrown was grandpa’s father” (Satrapi, 2003, p. 22). However, the story behind this was that oil was discovered in Iran. Marjane’s great-grandfather, the then emperor, refused to yield to the imperialists’ demands or the so-called Allies. With the help of the CIA, the imperialists overthrew the emperor and installed a puppet regime. Imperialism was not just about extending physical borders; it was also about economic pursuits, such as raw materials for industries and minerals. Oil, especially in the 20th century, was a lucrative commodity and a source of great wealth. The imperialists were determined to extend their economic position at the expense of other states that appeared weak and unable to defend themselves effectively. If a regime did not yield to the imperialists’ demands, its fate was clearly known; being overthrown from power.
Marjane would have lived a pretty comfortable life in Iran if the imperialists, with their selfish interests, had not poked into the affairs of the country. When Reza Shah was installed as king of Iran, he immediately confiscated almost everything Marjane’s great-grandfather owned (Satrapi, 2003, p. 23). This act could partly be symbolic; imperialists, often with their puppets, took away what rightfully belonged to the citizens of the countries they controlled. Imperialists looted countries’ resources, impoverishing the populations while they themselves developed their countries. Perhaps Marjane would have inherited some of the wealth of her great-grandfather. It is even a big possibility that her father would have been an emperor at one point if Marjane’s great-grandfather had not been overthrown so unceremoniously. Additionally, the country would not have been destabilized; peace would have somehow prevailed. Usually, with peace, countries can focus on developing in various aspects. However, overthrowing the regime by the imperialists created an unstable environment for citizens and foreigners who might have wished to live and invest in the country. Therefore, the imperialists’ actions affected Marjane’s life both directly and indirectly; it was her great-grandfather who had been overthrown, and the unstable political environment affected aspects such as education and self-advancement.
The revolution by the Muslim fundamentalists also changed the course of Marjane’s life. The fundamentalists changed Iran’s social life in a significant way. For instance, women and girls were now expected to wear veils, and using or possessing things from the West was banned. Marjane’s mother was harassed for not wearing a veil by fundamentalists. She says, “they insulted me. They said that women like me should be pushed up against a wall and fucked. And then thrown in the garbage…and that if I didn’t want that to happen, I should wear the veil…” (Satrapi, 2003, p. 74). People could not listen to music from the West, and anyone suspected of opposing the regime in power was arrested, tortured, and even executed. The fundamentalists had tight control of the control, striving to surveil the people and whip them into loyalty. For instance, Marjane, at one point, was arrested by the women guards for wearing sneakers and attire that was deemed to be from the West. Though she had her veil on, the guards decided she had not dressed as expected. The unbearable life marred by arrests and torture of Marjane’s relatives would later make her parents send her to Austria, where she would be safer. The Muslim fundamentalists in Iran would even revise the education curriculum to remove elements of western education. Clearly, the revolution compelled Marjane’s family to send her outside the country to secure her future and place her on a positive trajectory.
In conclusion, Marjane’s life trajectory was mainly changed by imperialism and the revolution. The imperialists somehow changed her family’s fortunes from comfort and royalty to inactivity and worry about their future. The revolution ultimately pushed Marjane outside the country to Austria. It was no longer safe to live in Iran; staying there would spell doom for her. If the imperialists had not arrived in Iran and the revolution had not taken place, Marjane would have lived in royalty, and the country might have been peaceful and stable. Marjane would never have left the country to pursue a brighter and better future.
Satrapi, M. (2003). Persepolis: The story of a childhood. Pantheon Books.