Questions

QUESTION 1 Diversity

Changes in the composition of the U.S. population may alter the demand for health services in the future. Several demographic changes are likely to affect future health care demand and participation. These include the average age is increasing, the proportion of racial and ethnic minorities is increasing, and the proportion of urban residents is increasing.

• Leveling of participation rates in most activities seems to occur as the individual reaches middle age. Participation in physically strenuous activities starts to decline at early ages, with participation in other activities beginning to decline later in life. Exceptions are walking and observing nature, which are enjoyed by people of all ages.
• Significant differences in recreation participation occur between different racial and ethnic groups. For example, Caucasians and Hispanics had significantly higher participation rates than African Americans in almost all health care activities. Participation rates for exercise activities are higher for African Americans and Hispanics than for Caucasians.
• Rural residents are more likely to participate in activities associated with grassland areas than their urban counterparts. Urban residents are more likely to participate in activities requiring specialized facilities. These differences reflect the availability of health care access and opportunities in close proximity.
• The implications of demographic changes for future health care behavior are difficult to predict. Recreation resource managers may face reduced growth in the number of customers, increased customer diversity, and changing demands for activities, the design of settings and facilities, and visitor programs.

Based on these thoughts; how will you proceed with your program taking all four of these into account? Your response needs to cover future health care planning with these four aspects taken into consideration. As well, your response needs to cover health care disparities.

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QUESTION 2 Health and Exercise Science

1. Define, discuss and elaborate upon a clinical presentation that a patient in your care may experience. Be specific in any diagnostic imaging, laboratory tests and special tests that you may need to use in the diagnosis and treatment of your patient. Please elaborate upon the etiology of the clinical presentation, patient case history, pathophysiology of the condition, basic anatomy and physiology of the structure involved in the diagnosis and any and all evaluative procedures. Be clear and specific on this.
2. You are strength coach at a major university. Develop a plan of action in which you would use for summer conditioning. Be specific in your explanation and cover all the phases of a summer conditioning program.
3. You are a physical therapist or an athletic trainer at a major health care facility. Define the role and responsibilities as per knowledge, skills and abilities in either being a physical therapist and/or athletic trainer. Be sure to include licensure, continuing medical education and how one plans to practice as a licensed professional as per ethics of your chosen field.

QUESTION 3 Professional

This item is to discuss your particular leadership qualities.

1. Define your particular leadership qualities.
2. Define how these will make you successful in running a health care organization.
3. Name and describe those aspects that will help you continue to be an effective leader.
4. Leaders have been known to divide their time into three areas. These areas are for handling finances, quality control in programming and for building relationships. Describe and define these areas and how you see yourself fulfilling each of these areas.

QUESTION 4 – Facilities and Programming

This item is to assess your knowledge of facility management.

1. Describe a facility that is commonly used in the sports/recreation area. Be sure to cover all the aspects of the facility such as location, strengths, weaknesses, opportunities and threats (SWOT).

Once you have defined this facility:

1. Develop THREE program areas that would complete a health initiative in your chosen field.
2. Define your target population for each of the three program areas as well as define either the rehabilitation or treatment areas of need.
3. Describe scheduling, funding, community needs, volunteer training, staff development as well as the promotion of your program for each of the three programs you envision.

Answers

Future Planning for Health Services

             Demographic changes in USA dictate the future planning of the health services and the form they should take to be all inclusive.  One of the main components of healthcare as outlined by the WHO (2018) towards the achievement of Universal healthcare is empowering communities and persons. Health services provision should be tailored in a way in which the individuals, families and communities are thoroughly equipped through empowerment of the health related services.  The empowered communities can at least gain access to primary healthcare services and preventive measures (WHO, 2018).

              The participation in the physical activities in provision of healthcare seems to decrease with an increase in the number of the   age among the different ethnic communities. Future planning of health services should be inclusive of the varying dynamics in the ethnic groups such as mortality rate.  The majority of the Hispanics and African- Americans due to the social factors as well as economic factors may lack the necessary facilities for continual participation in the physical activities early in life. The decreased participation in physical activities as dictated by the increase in the age of the various participants may ultimately lead to the worse functioning of the body later on in life.

            The empowerment of the communities living in the rural areas should be through setting up facilities in the rural areas where the communities have free access due to their constrained standard of living. Ultimately, the communal physical exercises area can be funded by the government both the local and national government to ensure smooth running of its affairs. The  elderly members of the communities  through the guidance of the fitness instructors can be encouraged to visit the recreation centers and participate in less straining activities which are better than taking a walk and  observing nature. The presence of an elderly person in a company of aged persons who are involved in some kind of physical activities will encourage their participation in similar kind of activities. The fitness instructors should match the ethnic background of the elderly persons for full participation in the services.

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             In addition to setting up the programs concerned with the promotion of the health of the elderly, the Health Services should have a program for the elderly illustrating the need for the physical activities in their routine practices. The program should be location and age specific to optimize on the number of individuals that can be reached.  The program should be illustrative of the frequencies in the exercise and the dietary changes that should help in reducing too much fatigue especially after working out.

             WHO (2018) alludes one strategy of ensuring proper health services for the different demographics in the USA population is addressing the underlying barriers in provision of health services. The demographic constitution may limit the kind of activities inhabitants of a particular location engage in.  The rural population empowerment shall be through seeking various means of facilitating the inclusion in the physical training and helping avail the specialized facilities needed for training. The availing of the facilities shall help in dealing with one component of why people are not getting involved in the specific kind of activities.  The empowerment of the residents of the urban areas shall be through the availing of open areas where the individuals can easily get to train in a different scenario from the traditional specialized facilities. Thus, the future of the health services provisions shall entail the involvement of more stakeholders in dealing with the financial implications of the facilities provided and program development. The Health Services Sector may seek grants to fund their projects as well as financial aid from governmental institutions.

Clinical Presentation of a Patient

             The patient case history was presented in the course of diagnosis of the prevalent condition. The patient positively identified with the existence of the previous knee injuries in the course of the participation of the Basketball tournaments. The patient attributed the existence of the previous injuries to the sudden wrong landings always emanating from the false moves during play. The current injury, according to the patient emanated from a sudden land during the game tournament that led to the knee producing a sharp pain followed by a sharp excruciating pain.  While in the previous injuries the play recuperated and got back to play, the present injury has taken time to heal. The patient is currently unable to bear his weight and has difficulties in maintaining the right posture while walking.  The patient sought treatment at the college clinic but the recovery process has taken longer than anticipated.

             The diagnosis of the patient is that he may be suffering from non-contact ACL injury. As illustrated by Aoyama et al (2018), most of the ACL injuries are non-contact. The patient symptoms such as: the inability to walk properly, excruciating pain on the knee, the pop sound  during injury and  the prolonged time before resuming normal play are all indicators of the non-contact ACL injuries.  The diagnosis was preceded by the physical examination of the patient starting with the standing alignment of the patient while wearing shorts (Aoyama et al, 2018).  The examination shall start with the contralateral followed by the affected side in determination of the baseline of the patient.  Radiographs and MRI imaging will be undertaken to fully understand the extent of the ACL injuries and if any meniscal tears are present.  Since, there is suspicion of the flexion dislocation of joint muscles, the palpation exercises shall be performed to affirm the suspicion on  the diagnosis.  After palpitation exercises, the  flexion exercises shall be undertaken to determine the extent of the injuries  on the far that the muscles can flex. Specific ACL tests such as the Latchman tests.

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             Pathophysiology of the ACL injuries  describes the lack of knee stability to be among the resultant factors in the ACL injuries. The rapture of the ACL injuries is a common phenomenon often occurring in sports person.  A knee injury caused by ACL has an ATT that extends 10 to 15 mm at 30° of knee flexion under 134 N of anterior load (Zantop el al, 2007). The knee muscle finds it hard to bear the load of the weight of the body making movement a complicated task for the concerned persons. . Tsuda et al, (2001) posit that the proprioceptive fibres, muscles and ligaments work together so as to produce the much needed knee stability through a knee arc. The abnormal physiology of the knee muscle emanate from the failure of proper neuro-mechanisms that are attributed to the failing muscles of the knee injury.  The sudden knee movements such as during games time could easily lead to the occurrence of the knee injury. Presence of the Oestroathritis could be among the causation factors of the knee injury (Musumeci et al, 2017).

             ACL knee tissues generally have longer hamstring contraction latency as compared to normal ACL tissues.  Elongation of the tissues during the moments of creep is indicative of the prevalent injuries. The abnormal structure of ACL injury comprises of   thinner femoral insertion averaging at less than 3 mm thickness and a width of 8-11mm. The tibial insertion point was normalized into a C like structure.   The non-contact ACL injuries are prevalent in most of the sports persons and are indicative of the nature of the causation agent.

             The patient suffering from the ACL injuries needs proper treatment procedures. The operative measures in  management of the ACL injuries are used in ensuring total recovery for the patient. The treatment procedure shall commence with the Imaging to detect the extent of the injury, dislocation of the joint and the extent of any tears.  The reconstruction of the ACL muscles  mostly entail the use of grafts. The commonly used grafts are the the Hamstrings graft, bone-pollar-tendon graft and quadriceps tendon-bone.

Summer Conditioning Program

             The length of the play time is dependent on the strength training that one undergoes in the course of their training.  The students are encouraged to at least exercise thrice in a week with the cardiovascular training as well as the muscle strength and endurance training.  In order to avoid the heat of the day, the exercises should be conducted either on early morning or in the evening.  Each work out should be preceded by five minutes of warm exercises and end with some minutes of jogging.   For Cardiovascular endurance ensures that you do the J-S-W run at least every day of the week and the shuttle work. The shuttle exercise can entail the ladders, 120 yards or 300 yards shuttle exercise.  Inclusion of the aerobic and anaerobic activities with variance will help stem out boredom in the cardiovascular exercises.  Muscular Strength and Endurance shall include a range of push-ups and crunches. The amount of the push-ups and crunches can begin from the basic ones, to the ones entailing abdominal flexing. The amount of the push-ups and crunches increases from week one onwards as the body gets more accustomed to the exercises.

Role and Responsibilities of being a Physical Therapist

            A physical therapist engages in activities geared towards fully recovery of injured trainees.  The physical therapist helps in obtaining the patients history and diagnosing the patient as well as recommending the ideal treatment plan.  The main role of the physical therapist entails the use of the prescribed treatment options in the reduction of the pain among the injured players as well as helping restore the normal functioning of the body while avoiding the disability onset in the patient’s body.  He reviews the patient’s condition and the treatment plan to determine the appropriate kind of the physical therapist treatment needed.  Also, the physiotherapist reviews the patients’ conditions and determines the extent to which the physical therapy treatment will need adjustment.

             Physical therapist administers the physical exercise to maintain the motion and function aspect of the physical body parts. Some of the activities include massaging the victim’s body so as to stretch out certain muscles.  The physical therapist includes the components such as the involvement of equipment like hydrotherapy tanks and whirlpool baths, moist packs, ultraviolet and infrared lamps, and ultrasound machines.

             The Physical therapist position requires the position holder to be a graduate of an affiliated PT degree.  The position holder is required to possess good cognitive skills.  In addition, the position holder should be licensed through the State licensing board; the position holder should additionally have a one year post graduate experience.  The physical therapist is required to continually seek knowledge so as to identify the new treatment options in the medical field.  The physical therapist job is demanding of the physical strength of the position holder as it entails long periods of standing.

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 Leadership Qualities

             I possess the leadership quality of self-managing. I can strategically formulate goals for the health goals and follow them through in order to achieve the set objectives. I have learnt to manage my time while taking care of emotions so that they do not supersede my strengths. Additionally, I can effectively allocate timelines for different projects to ensure there is timely delivery of the required objectives.  Over time I have learnt the art of balancing personal and professional life. I handle issues separately ensuring all work related functions remain professional.

            I have the capability of thinking strategically. Sometimes, optimal functioning may entail a change of the tactics such that the current occurrences are taken care of. Thus, I maintain a positive outlook in all issues of life while being flexible to a change of idea or strategy.  In my strategic thinking, I focus on the future perspective of things. For instance, I  focus on what kind of services that a health organization should be providing so as to remain relevant in the community it is operating in.

             I believe that communication in a business enterprise is important as it does not just help in outlining the roles and responsibilities of the individual members but does help in building up ideas and business skills. I communicate through verbal and non-verbal cues to different departmental levels of operation such as the seniors and junior members to me in an organization ranking. Communication helps me in engaging people in all aspects of the business activities.

             The leadership qualities outlined shall help in efficiency in running a healthcare organization.  Self- management will influence the manner in which the overall business management shall be conducted. For instance, the identification of the strengths shall help in advancing my capabilities while benefitting the operational capabilities of the organization.  The ability to delegate the tasks shall minimize the amount of time required in the accomplishment of a task. The ability of separating the professional and personal life eliminates the use of emotions in leadership. Personal life is prone to have emotional and stressful seasons. The ability of controlling these aspects of the personal life shall ensure that the professional life remains steadfast and as such work flow remains uninterrupted.

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             Strategy determines the success of the goals and objectives enlisted in an organizational setting. The strategic thinking capabilities enable the organization to function optimally through the flexibility in re-strategizing to cope with the demands in the service provision and client satisfaction.  Additionally, the strategic leadership quality shall help in forecast of the future demands in an organization and acting according to the growing technologically inclusive environment.

             In additional to the current leadership quality, there are distinct elements that would help the health organization is the learning agility.  Treatment procedures in hospitals and new medical procedures require learning so as to be technologically relevant at the provision of the services. Thus, I need to learn continuously to ensure that the treatment measures are in accordance to the prevailing standards in the market.  Also, I need to be emphatic in the manner that I treat other individuals as well as the patients. Empathy enables one to undertake the necessary procedures in ensuring swiftness in service provision.

             In my leadership   in the organization I will allocate time in handling of the finances. The time allocation shall comprise of regularly reviewing the budgetary allocation. The regular review of the budget shall help in eliminating any kind of irregular spending’s or overspending which should be avoided.  The handling of finances shall incorporate aspects of savings so as to cover any eventualities that may cause an increase in the overall spending in the organization.

             Relationships in business settings are the foundation of exemplary performance. I have got several ways in which I will use in building great relationships with the community of health workers I will be working with.  To begin with I will be a great listener. Keen listening will help in identification of the emotions that are related to the  information being communicated. The listening shall help in the communication to the concerned parties.  I shall seek to establish shared values with the individuals we are working with. Some of the shared values shall be honesty, attention to details and empathy.  Through goal setting, I shall help build the relationship with the involved persons. The goal set shall be broken into individual task such as team work shall be developed through teamwork.

            Quality control in programming is an important element in the service provision in the health sector. I will constantly check on the accreditation form the relevant ministries to ensure that there is compliance in every kind of regulation.  The various employees in the health organization shall be required to have the necessary certification required so as to be deemed fit for service provision. The treatment procedures inclusive of medication and equipment in service provision shall be constantly upgraded to ensure quality is adhered to. I shall constantly check on the developments in licensing, compliance and research on the medical field to view any developments in the manner of service provision.

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Facilities and Programming

             The basketball court is among the commonly used facilities in the sporting arena the following is the SWOT analysis of the Basketball court Facility.

Strengths        All weather playground          Does not require much space        Ease in tracking the movement of the players No special equipment needed in playing within the courts	Weaknesses Players easily gets bruised during games Requires additional funding for initial setup Constant maintenance is needed Restrictive to only one game
Opportunities     Holding tournaments regularly  Improve unused area	Threats Poorly done surface can start chipping off Limited funding for new developments

The facility can help in the development of three programs with distinct target populations and funding mechanisms. The main goal for each program is an improvement of the health of the target population.

Rural Empowerment Program

            The program in the facility is targeted on the rural young people below 30 years who are still physically strong to conduct cardiovascular activities. The program shall be in the form of coaching with a fitness instructor. The young multicultural individuals shall be required to register at the facility for free.  The program which shall run for more than eight weeks shall begin with an open session on the importance of exercise in addition to nutrition on the primary health care. The group of the registered team members shall have an opportunity of asking any question concerning the fitness program to the fitness instructor as well as to the health officer.

            The rural youth empowerment program shall need funding to pay the facilitators and provision  of healthy snacks to the team members. The  program shall seek funding from the National Health Sector  with a focus on the empowerment of the young people and inculcating a culture of healthy physical exercises.

Rural Elderly Persons Empowerment

            The second program shall have the target audience of the rural elderly population who might not be fully involved in physical exercises. The program shall be all inclusive from the light exercises to the playing of basketball after training. The program aims at introduced the elderly persons to an active physical exercises procedure that will improve the primary health care. The registration forms for the health service shall be availed in the health and nutritional facilities. Interested members shall be invited to join the program free of charge to encourage an increase in the number of members in the facility during the program.  The choice of not charging for the program is due to socio-economic status of the rural community who might not afford the programs due to low income status.

            The program shall seek funding from the WHO and the rural based health programs that are often attached to main hospitals. The funds raised shall help in the compensation of various persons involved in the program such as the fitness coach.

Urban Elderly Persons Empowerment Program

             Just like the elderly persons in the rural areas, the elderly persons in the towns may be having a limited nature of the activities that they are involved in. The program shall be geared towards ensuring that elderly persons in the towns get involved in  more physical programs apart from walking. The registration forms capturing all the relevant data on the  team members shall be availed in the hospitals and local stores. Just like the former two programs, the program shall run for eight weeks on a regular basis. The fitness coach shall help the program members on which kind of exercises to undertake. The health coach shall enlighten the team members on the need of comprehensively undertaking the active exercises as a fitness measure. Volunteers shall be requested to join the program to help in motivation of the elderly persons.

            The program shall seek funding from WHO in running of the program. The funding shall help in footing the expenses related to hiring a fitness instructor and the health coach. The basketball pitch can be refurbished accordingly.

References

Aoyama. T.J et al (2018,). Clinical Evaluation of ACL Tear. Musculoskeletal Key. https://musculoskeletalkey.com/clinical-evaluation-of-acl-tear

Musumeci, G. (2017). Functional Anatomy in Knee Osteoarthritis: Patellofemoral Joint vs. Tibiofemoral Joint; Multidisciplinary Digital Publishing Institute: Basel, Switzerland, 2017

Tsuda, E.; Okamura, Y.; Otsuka, H.; Komatsu, T.; Tokuya, S.(2001) Direct evidence of the anterior cruciate ligament-hamstring reflex arc in humans. Am. J. Sports Med. 2001, 29, 83–87.

 WHO (2018) A Vision for Primary Health Care In The 21st Century Towards universal health coverage and the sustainable development goals. (n.d.). https://www.who.int/docs/default-source/primary-health/vision.pdf

Zantop T, Herbort M, Raschke MJ, Fu FH, Petersen W.(2007) The role of the anteromedial and posterolateral bundles of the anterior cruciate ligament in anterior tibial translation and internal rotation. Am J Sports Med. 2007;35:223–227.

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