Answer key
Activity 3.1 Defining empire
1. Answers:
Empires are large and powerful.
Empires control lands and peoples taken by conquest.
Empires exist by military or economic force or a combination of the two.
Empires usually attempt to standardize things such as weights and measures to facilitate trade within the empire.
2. Answers:
Because the armies of Sargon and his successors extended their military conquests farther from the Mesopotamian heartland than any leaders before them.
Because Naram-Sin employed titles such as “King of the Four Quarters,” which essentially meant “king of the world.” This type of grandiose title gave the impression that the king controlled great expanses of the world. Such titles had not been used in Mesopotamia before the time of the Akkadians.
Because they centralized everything from accounting practices to the way years were named, and made some effort to standardize weight measures and language. Because we know they appointed conquered leaders as their vassals.
Activity 3.2 Law and society in the Code of Hammurabi
1. The kings presented themselves as representatives of the gods, mandated to ensure justice and harmony in their name.
2. Answers:
They tell us that the wages for certain jobs were fixed by the king and the government to ensure that the workers were paid a fair wage so that they could support themselves and their families.
They tell us that wages depended on a person’s social class and occupation, not on how good they were at their job or how fast or slow they worked.
Wage differences reflected social differences. People were not all equal and they did not all deserve the same treatment. The ancient Babylonians believed strongly in the separation of social classes, and this belief is demonstrated in their legal structure.
3. In these laws, two men of the same class receive a similar punishment for causing the loss of an eye. By our standards, we might detect some sense of fairness in this law, since the one who commits the act receives the same treatment as the offence committed; a true demonstration of the legal concept of “lex talionis” described on page 65 of your textbook. In the two clauses that follow, however, we read that if the awilum should blind the eye of a mushkenum (commoner), he simply pays a fine of 60 measures of silver. If he blinds an awilum’s slave, he only pays half the value of the slave. In these laws, it is clear that a commoner is worth less than a man of the awilum class and a slave is worth even less.
4. Answers:
This law tells us a great deal about Old Babylonian society. Belief in magic and the supernatural was quite common. Everyone believed that things could be caused by unseen forces and that certain people could cause their neighbours harm by using magic and witchcraft.
Not all legal cases could be judged by humans. Sometimes cases had to be judged by natural forces such as the Euphrates River.
Because laws dealing with witchcraft appear at the beginning of the Laws, we can deduce that many people were resorting to charges of witchcraft to punish or do harm to their neighbours and that these accusations were taken very seriously. The harsh punishment for false accusations is meant to dissuade people from using the law against their neighbours.
5. Answers:
Under Law 117, a debtor’s wife or daughter may be taken to work in the debt holder’s house for up to three years. No similar mention is made of the father or his sons.
Under Law 129, a woman is punished for adultery by death. The man is punished not because he has committed adultery, but rather because he trespassed on another man’s wife. No similar law against male adultery exists.
Under Law 138, a man can legitimately divorce his wife if she is barren.
Under Law 141, if a wife behaves in an unacceptable manner, her husband can divorce her and she will receive no divorce settlement. If the husband decides not to divorce her, he can keep her in his house as a slave and marry another woman. Once again, no equivalent law existed concerning men.
In order to divorce, a woman has to refuse to sleep with her husband and have her character scrutinized by an all-male assembly or city council. Divorce was very easy for a man to obtain and no enquiry into his conduct was undertaken.
Activity 3.3 The Assyrians and war
1. Answers:
To steal goods and products from their neighbours: war as national theft.
To attack their enemies before being attacked by them.
2. Answers:
Raids or razzias, which were simply campaigns used to gather loot or booty by means of armed theft.
By besieging a city or town and starving the inhabitants until they surrendered.
Assyrians could call up local levies of citizen-soldiers who fought on a part-time basis after their farm work was completed every spring. They also created a full-time professional army of officers and career soldiers who became very proficient warriors.
The Assyrian army was made up of foot soldiers, who formed the bulk of the fighting force, augmented by mounted cavalry soldiers and a chariot corps as well.
3. Answers:
Yes, particularly in the early phases of their empire. Because the Assyrians were often better organized and trained than their adversaries, this made the difference on the field of battle.
Later on, when many of the soldiers in the Assyrian army were drawn from the ranks of defeated countries and were no longer native Assyrians fighting for their homeland, the army began to weaken.
The Assyrians did employ some technologies that may have given them a slight advantage over their enemies. There are few examples of the use of siege towers before the Assyrians, and it appears that the use of siege towers to breach walls was developed and refined by the Assyrians.
The use of archers and slingers was wide-spread in the ancient world, and the Assyrians employed technologies already known for some time. The same is true of chariots, which were well known and in use by the Egyptians as early as the New Kingdom, at least from the 15th century BC onwards. Assyrian success with such weapons may have been enhanced by better training and better use of such weapons in the field.
4. Answers:
Hunting was a way of training and toughening up young men to prepare them as good soldiers for war. “Dangerous” and powerful animals such as lions, elephants, and wild bulls were hunted.
Hunting was generally carried out by trained and well-armed soldiers who had the expertise to face ferocious wild animals. Except in rare instances, hunting was normally not carried out by local farmers, because they possessed neither the weapons nor the skills to face wild carnivores, powerful elephants, and massive wild bulls.
Activity 3.4 The Assyrian Empire
1. The Assyrians cultivated a reputation for cruelty to strike terror and fear into the hearts and minds of people they wanted to conquer or control. They made a point of “making examples” in order to intimidate their enemies. Often, after gruesome public displays of violence, besieged populations were so frightened, they did not resist but simply gave up.
2. They used mass deportations as a way of breaking up peoples who were prone to revolt or cause trouble for the Assyrians. People suddenly uprooted to foreign lands tended to cause fewer problems.
3. A system of messengers that could speed messages across the empire in a matter of days was a vital element of Assyrian control. If a revolt broke out, troops could be sent quickly to the troubled area.
4. To consolidate power, Assyrian kings used whatever worked. Sometimes, instead of conquering a land, it was better to leave local rulers in power but demand annual payments of tribute from them. If that did not work, they might decide to conquer the land and administer it directly. In extreme cases, they would deport a large part of the population and replace it with subject peoples.
Activity 3.5 The limits of empire
1. Babylonia was the cultural and intellectual centre of Mesopotamia. Since the time of the Akkadians, 1500 years before, southern Mesopotamia had been the cultural heartland of the ancient Near East. Traditions of law, literature, and religion came from the south. Many of the gods and religious practices, as well as laws, mythologies, and other cultural elements shared by the peoples of Mesopotamia, came from Babylonia. This meant that the Assyrians usually treated Babylonia with great respect until Sennacherib burned the city of Babylon and ravaged the countryside. In addition, the peoples of the south wanted to run their own kingdoms and did not want to be controlled by the Assyrians.
2. Civil war and revolts are part of most empires. Conquered peoples were usually repressed by their conquerors and often used simply as a source of goods to be exploited until they revolted. The Assyrians often ruled conquered peoples with a heavy hand, which left the victims impoverished and without any way to improve their conditions. Revolts could also occur when a conquered people perceived weakness in their imperial overlords.
3. The Assyrians overextended themselves on many fronts.
They failed to take into account the realistic limits of their ability to govern and control a distant land which was hostile to them. After the Assyrians pillaged, looted, and burned the land of the Pharaohs, they expected the Egyptians to behave themselves and bow to Assyrian demands. After being robbed and pillaged, the Egyptians were in no mood to be nice to their conquerors.
Because of the very volatile nature of the Assyrian Empire, there were numerous revolts on all fronts. This meant that Assyrian military forces could not stay in Egypt as an occupying force. Troops had to go elsewhere in the empire and quell other revolts. Once the troops were gone, the native Egyptians put one of their own people on the throne and kicked the Assyrians out of the country.
The logistical problems of supplying soldiers who were sometimes over a thousand kilometres away with pack animals, horses, chariots, and weapons eventually became insurmountable.
KNOWLEDGE: The Civilizations of Ancient Egypt and Mesopotamia 345-101-MQ (65.1)[supanova_question]
Running Head: GUN LAWS REORM IN AMERICA GUN LAWS REORM IN AMERICA
Running Head: GUN LAWS REORM IN AMERICA
GUN LAWS REORM IN AMERICA
Gun Laws Reform in America
Karen Gonzales
English Comp
8/5/2021.
The question whether stricter gun laws will reduce the rate of mass shootings as currently witnessed in the United States has continued to raise more debate globally. For instance, the frequent cases of mass shootings in churches, schools, and mosques around the United States have led to a debate on the reforms to current gun laws. Different sides of the debate have taken tough stances on the approach that is to be made to reduce cases of gun violence. Conservative America has mostly defended rights to own firearms, including semi-automatic rifles. In contrast, the liberals have argued that access to automatic rifles should be restricted by the government and laws ensuring background checks are introduced. Whether stricter gun laws would reduce mass shootings has divided America further, especially by political parties giving the debate a political approach. However, stricter gun laws would greatly reduce the amount of gun violence witnessed across the United States.
The gun laws of the United States are mainly controlled by the federal law known as the 2nd amendment. The second amendment gives all eligible United States citizens the right to own and bear guns for their protection (Cornell & Cornell, 2018). The federal government has set the minimum age of owning a gun at 18; however, state governments can increase the minimum age of a firearm owner. With a gun ownership permit, anyone can purchase a gun from local dealers or on online platforms. The guns purchased are short rifles, silencers, firearm mufflers, and automatic weapons made before 1986. Laws to receive or possess guns are set at state levels, and, similarly, the state decides whether it is acceptable to carry guns in public or not. Gun dealers require a permit from the Bureau of alcohol, tobacco, firearms, and explosives to sell guns to citizens. Fugitives and those with mental illnesses are not allowed to own or purchase firearms. The 1968 gun control act requires the federal firearm license to conduct a background check before issuing licenses to own firearms; the background checks are meant to identify and review the criminal background data on individuals. Gun laws allow the transfer of ownership of a gun to another individual without any government monitoring the process. Under this law, a parent can give guns to their underage children as a present without violating any law. According to James B Jacobs, a professor of law at New York University, the fact that there are over 300 million across united states guns in private hands making it nearly impossible to prevent guns from getting into the wrong hands. The federal government’s scheme is incomplete and falls too short. Whether an improvement can be made is an open question.
The debate on gun violence must include an analysis of some of the worst cases of gun violence in recent times and a review of statistics relating to guns. Mass shootings have become one of the common cases of death in America (Bauchner, Rivara & Bonow, 2017). Two hundred fifty-five mass shootings have occurred in America since 2009, leaving 1449 people dead and 961 people wounded. The Las Vegas strip massacre of 2017 and the Orlando nightclub massacre of 2016 stand in history as the worst mass shootings in American. The Las Vegas strip massacre occurred when a 64-year-old man opened fire on a crowd attending the harvest music festival from his hotel floor at Mandalay Bay. The massacre left 60 people dead, 411 with gunshot wounds, and over 8-00 people injured due to the resulting commotion. He fired a total of 1000round of ammunition, using what’s referred to a bump stock that allows firing at a rate similar to automatic weapons. It stands s as the wor4st case of mass shootings conducted by an individual. The Orlando gay night club massacre occurred when Omar Mateen opened fire, killing 49 people and wounding 53. The use of high-capacity magazines by the perpetrators ambled them to continue shooting for a longer period, leading to more casualties.
School shootings are some of the most disturbing consequences of gun violence in the United States. It is estimated that three million children are exposed to mass shootings in the United States per year. Since the tragic columbine school shooting, a total of 11 deadly mass shootings has occurred at schools. The statistics on gun violence and mass shootings in the United States invites a thorough discussion on gun laws in the United States. In addition, it should be considered what other countries have been doing such that they have lower instances of gun violence. Finally, the statistics on gun violence in the United States provide a rallying call to all citizens, especially lawmakers, to provide a solution to the surging cases. Most people agree that a solution should be found as fast as possible.
The high rate of gun violence in the United States indicates differences in factors involved in gun regulations compared to other countries. Switzerland provides a perfect case study for gun laws. Despite the country having a high number of guns per capita than the United States, the case of gun violence is considerably low. The country has developed strict gun laws that ensure that guns don’t end upon in the wrong hands. In addition, the country has mandatory military training that provides necessary information’s on handling guns to citizens.
In comparison to the United States laws, some states do not enforce and require training of firearm holders to ensure proper handling. The country also ensures thorough background searches are conducted on individuals with licenses to own firearms. In Canada, gun laws have often changed in response to t5he issues that come up. In Canada, it is fully illegal; to own an automatic firearm unless it was registered before 1978. And guns and semi-automatic weapons are highly restricted. The only type of unrestricted guns is short guns and rifles. Following a mass shooting at Quebec mosques, a law was put in place that responded to the incident. This was by increasing the detail of background checks before being allowed to own a gun. In Australia, the government began a campaign to buy back automatic weapons after declaring them illegal. In Israel, compulsory military training provides the citizens with indirect access to most types of firearms. However, the country has a strict gun laws. The minimum age for owning a gun for any Israeli citizen is 21 if they have military training or 27 if they don’t have military training. The United States gun laws are very different from the gun laws of the other parts of the world. The fact that mass shootings in other countries are lower and yet the countries have stricter4 gun laws is a clear indication that the problem we have in the United States is closely related to gun laws.
The arguments by pro-gun advocates fail greatly when scrutinized for their validity. The conservatives in America have been at the forefront of fighting against gun laws reforms (Crummett & Swenson, 2019). The Republican Party has rejected several bills in congress and the senate that seeks to reform current gun laws in the United States.
One of the most common arguments that pro-gun advocates provide is that gun restrictions would violate the rights to own guns provided by the second amendment. The second amendment gives every United States citizen the right to own guns, but that does not mean that there could be violations of that right. Everyone has a right to free speech; however, there are restrictions to this right, i.e., one has no right to speak in manners that are insulting, or that might be perceived as hate speech. The other argument is that gun control would lead to a ban on guns. The argument fails when comparisons are made to several countries that have introduced gun reforms yet have not gone to the extent of banning guns, such as in the United Kingdom and Germany. The other argument is that gun control would restrict people’s right to self-defense; the argument fails for stricter gun laws would still allow eligible people to defend themselves.
The strongest argument for pro-gun advocates is that bad people would still get guns even if restrictions were implemented. It is a popular saying that the only person who can stop a bad guy with a gun is another guy with a gun. However, the argument fails to consider the fact that the possibility of an occurrence of crime does not invalidate the law. Some of the commonly abused drugs, like heroin and meth re, are used in medication processes. The drugs have been restricted, and laws govern their use despite other individuals’ widespread illegal use. Gun laws have worked in other countries, and they will probably work well if implemented nib United States. It should be undertood that the main purpose of gun reforms secures the right of citizens to own firearms; it does not seek to take guns away from citizens as has been propagated by the thought far-right groups of the United States.
In conclusion, the gun laws currently in place should be reformed to reduce the causes of gun violence in the United States. The arguments propagated by the pro-gun advocates fail to consider important aspects of the gun debate. The examples of other countries on reforming gun laws should act as a lesson for Americans on dealing with gun violence.
Reflections
In the paper, I have used rhetorical appeal in the second last paragraph to try appealing to the pro-gun advocates to rethink their stance on the debate based on gun violence statistics. Have also used rhetorical appeal in the third paragraph. It appeals to the reader’s emotion to regard some of the consequences of gun violence that have been experienced in the past decades. Some of the important feedbacks that would assist in the revision of the paper would be an analysis of the statistics used in supporting the arguments on whether they are adequate or not. The political opinions that the essay reflects could also be analyzed to ensure that they represent the real stances of the party. Finally, the analysis of the strength of the argument could be analyzed to ensure that they are convincing.
Annotated bibliography
Bauchner,, H., Rivara, F., & Bonow, R. (2017). Death by Gun Violence—A Public Health Crisis. Retrieved 5 August 2021, from
In the article the authors analyses the rate of gun violence in the United States based on statistics from the previous decades, they describe the shooting at Las Vegas strip in2017. The authors an give detailed statistics for the numbers of deaths caused by gun violence per day on the different parts of the united states.
Cornell, S., & Cornell, E. (2018). The Second Amendment and Firearms Regulation: A Venerable Tradition Regulating Liberty While Securing Public Safety. Retrieved 5 August 2021, from
The authors of the article surveys the history of gun laws in the United States from the 18 the century, to the current laws .They briefly talk on gun violence history of the United States. They focus on explaining the development of the second amendments and its interpretation throughout history.
Crummett, D., & Swenson, P. (2019). Gun Control, the Right to Self-Defense, and Reasonable Beneficence to All. Retrieved 5 August 2021, from
The article analyses the arguments played by pro gun advocates and discuses some of the failures of the argument. The article provides answers to the objections raised by pro gun advocates by scholarly arguments.
References
Bauchner,, H., Rivara, F., & Bonow, R. (2017). Death by Gun Violence—A Public Health Crisis. Retrieved 5 August 2021, from
Cornell, S., & Cornell, E. (2018). The Second Amendment and Firearms Regulation: A Venerable Tradition Regulating Liberty While Securing Public Safety. Retrieved 5 August 2021, from
Crummett, D., & Swenson, P. (2019). Gun Control, the Right to Self-Defense, and Reasonable Beneficence to All. Retrieved 5 August 2021, from
Touchstone 3.2 Rubric and Feedback
Rubric Category
Feedback
Score (acceptable, needs improvement etc.)
Argument Development and Support
The essay is developed with supporting details to support the argument, but please read my comments for ways to strengthen the argument.
30/40
Research
The essay contains credible sources, but a little more supporting evidence is needed in some areas. Please read my comments for feedback.
22/30
Organization
Includes the elements of an argumentative essay.
15/15
Style
Demonstrates effective style choices.
5/5
Conventions
Few to no errors.
4/5
Reflection
Demonstrates thoughtful reflection responses.
4/5
Overall Score and Feedback: 80/100
Karen,
This is a good start. Please read my comments for specific feedback. I look forward to reading the final draft.[supanova_question]
3.4 Assignment: Case Study Getting Started In this section, we focus on
3.4 Assignment: Case Study
Getting Started
In this section, we focus on the functional-level strategies that managers can use to achieve superior efficiency, quality, innovation, and responsiveness to customers, and in so doing build competitive advantage. We also examine the nature of an organization’s value chain and discuss how the combined or cooperative efforts of managers across the value chain are required if an organization is to achieve its mission and goal of maximizing the amount of value its products or services provide customers. You will be able to understand the vital role value-chain management plays in building competitive advantage and creating a high-performing organization.
Upon successful completion of this assignment, you will be able to:
Understand the vital role value-chain management plays in building competitive advantage and creating a high-performing organization.
Compare and contrast leadership and management using critical thinking skills to address situations arising within a changing global business environment.
Evaluate appropriate interventions for organizational challenges in structure, control, and culture.
Create an ethical strategy and standard for leadership during decision-making and problem solving that considers a biblical perspective.
Develop a leadership strategy that deals effectively with conflict, negotiation, and organizational change.
Resources
Bible
Article: Battery Cell Production Begins at the Gigafactory
Article: Tesla has finally begun producing batteries at its massive Gigafactory
Article: The Real Story Behind Elon Musk’s $2.6 Billion Acquisition of SolarCity And What It Means for Tesla’s Future-Not To Mention The Planet’s
IWU Resources
Background Information
The implementation of new operations techniques, such as Just in Time, Total Quality Management, or flexible engineering, often requires a substantial shift in organizational culture for which employees must be prepared. The human cost of improving productivity must be acknowledged and thoughtfully balanced against other stakeholder concerns, since employee support is vital to any new undertaking.
Instructions
Review the rubric to make sure you understand the criteria for earning your grade.
For questions on APA Style, go to APA Style.
Read the following articles:
Article: Battery Cell Production Begins at the Gigafactory
Article: Tesla has finally begun producing batteries at its massive Gigafactory
Article: The Real Story Behind Elon Musk’s $2.6 Billion Acquisition of SolarCity And What It Means for Tesla’s Future-Not To Mention The Planet’s
Write a paper that answers the questions from the end of the case repeated here.
Describe how Tesla is creating a competitive advantage by bringing battery production in house.
How does Tesla’s decision to produce its own batteries impact management of the company’s value chain?
Do you think Musk’s recent decision to buy SolarCity will have an impact on Tesla Motors’ business strategies? Explain your reasoning.
Your paper should be 600 to 800 words in length. Use proper spelling, grammar, and APA formatting with in-text citations and references as needed for your paper.
When you have completed your assignment, save a copy for yourself and submit a copy to your instructor using the Assignment submission page by the end of the workshop.[supanova_question]
3.3 Assignment: Case Study—Social Media Risk and Reward Getting Started Sharing ideas
Writing Assignment Help 3.3 Assignment: Case Study—Social Media Risk and Reward
Getting Started
Sharing ideas and opinions is accomplished both in a business setting and with social media. Human resource departments use social media sites in recruitment processes. Technical people have been sharing ideas and troubleshooting on bulletin boards since the 1970s. Can social media websites be used beneficially in business?
Upon successful completion of the course material, you will be able to:
Evaluate the risks and rewards of social media in the workplace and the implementation of social media policies.
Resources
Bible
Article: 2016 Rio Olympics Bring Mobile, Social Media Risks
Background Information
Networking with friends and colleagues is necessary in today’s climate for employment. The mechanics have changed in that office water coolers are not the only place to talk to people about current events, strategies, and goals.
Instructions
Review the rubric to make sure you understand the criteria for earning your grade.
Read the article “2016 Rio Olympics Bring Mobile, Social Media Risks.”
Find at least three peer-reviewed journal articles on the risks and rewards of social media to add to your evaluation.
Write a two-page paper using APA formatting. The length of the paper does not include the title page and references.
For questions on APA style, go to the APA Style guide.
Use at least three sources published within the last five years for this paper. You may also use your Bible.
When you have completed your assignment, save a copy for yourself and submit a copy to your instructor by the end of the workshop. https://onlyassignmenthelp.com/index.php/2021/11/28/cookie-creations-case-study/ [supanova_question]
Forum 6 – Health Care Reform Myths and Realities, Vaccine debate It
Forum 6 – Health Care Reform Myths and Realities, Vaccine debate
It is perceived by some that expenditures on drugs are driving the health care affordability problem, but the reality is more complex. There many myths and misconceptions regarding health care and health care reform. Ethical issues in health care are also not uncommon. Almost any decision made in health care can have an ethical implication. These implications can affect patients, providers, and health care leaders. Health disparities and attitudes of End-of-Life-Care are just a few.
Vaccines: The Basics
Vaccines contain the same germs that cause disease. (For example, measles vaccine contains measles virus, and Hib vaccine contains Hib bacteria.) But they have been either killed or weakened to the point that they don’t make you sick. Some vaccines contain only a part of the disease germ.
A vaccine stimulates your immune system to produce antibodies, exactly like it would if you were exposed to the disease. After getting vaccinated, you develop immunity to that disease, without having to get the disease first.
This is what makes vaccines such powerful medicine. Unlike most medicines, which treat or cure diseases, vaccines prevent them (CDC, 2020).
Reading Assignments:
..
The Truth About Obamacare: 14 Myths Explained – The Balance
https://www.thebalance.com/the-truth-about-obamacare-3306075
Donald Trump on Health Care
How Trump Is Dismantling Obamacare
https://www.thebalance.com/how-could-trump-change-health-care-in-america-4111422
Health Care Reform Myths and Realities
http://www.bnaibrith.org/uploads/7/8/5/9/7859990/healthcare_reform_myths.pdf
Death with Dignity Act.” Washington State Department of Health. N.p., n.d. Web. 07 May 2015. http://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/DeathwithDignityAct.
Frequent Users of Emergency Departments: The Myths, the Data, and the Policy Implications
What Causes Racial Health Care Disparities? A Mixed-Methods Study Reveals Variability in How Healthcare Providers Perceive Causal Attributions.
https://doi.org/10.1177/0046958018762840
5 Facts about the in the U.S.
https://www.pewresearch.org/fact-tank/2019/03/19/5-facts-about-vaccines-in-the-u-s/
Discussion Questions: Use your reading assignments and/or additional resources to make your post.
Make 2 peer responses. No short responses.
Did the ACA provide basic health care access for everyone?
Should efficiency or cost be a driving force of health care?
Do you think expensive treatments like organ transplants should be limited due to disparities?
How might attitudes of healthcare providers contribute to disparities in quality or equity?
Do you think new health care law/reform is going to increase the cost of insurance premiums?
What is an advantage of a vaccine? What is a myth about getting vaccinations?[supanova_question]
Forum 5 – Health Policy Issues and Chronic Disease Chronic Disease and
Forum 5 – Health Policy Issues and Chronic Disease
Chronic Disease and Health Outcomes
The leading causes of death and disability in the U.S. are chronic diseases and conditions. An integrated care approach to managing illness which includes screenings, check-ups, monitoring and coordinating treatment, and patient education. It can improve your quality of life while reducing your health care costs if you have a chronic disease by preventing or minimizing the effects of a disease (CDC 2017).
About 80% of older adults have one chronic condition
88.4% of Medicare beneficiaries have 2 or more chronic conditions and 36.4% have 4 or more.
Chronic diseases can affect a person’s ability to perform important activities, restricting their engagement in life and their enjoyment of family and friends. 2/3 of all health care costs are for treating chronic illness
95% of health care costs for older Americans can be attributed to chronic disease (National Council on Aging 2018).
The Chronic Care Model
CCM is designed as an organizing framework for improving chronic illness care. It is plan for improving care at both the individual and population level. The model is based on the assumption that improvement in care requires an approach that takes into account patient, provider, and system level interventions (Improving chronic illness care, 2006-2018).
Diabetes
An estimated 30.3 million people of all ages – 94% of the U.S. population have diabetes. 23.1 million are diagnosed and 7.2 million, 23.8% of people with diabetes are undiagnosed.
The percentage of adults with diabetes increases with age and is greatest among those aged 65 years. Diabetes is the leading cause of CKD/ESRD.
Diabetes is 7th leading cause of death
$245 billion: Total costs of diagnosed diabetes in the United States in 2012
$176 billion for direct medical costs
$69 billion in reduced productivity
(ADA, CDC, NKF, 2018).
Hypertension – High Blood Pressure
About 75 million American adults (29%) have high blood pressure—that’s 1 of every 3 adults.
Only about half (54%) of people with high blood pressure have their condition under control.1
Nearly 1 of 3 American adults has prehypertension—blood pressure numbers that are higher than normal, but not yet in the high blood pressure range.
High blood pressure costs the nation $46 billion each year. This total includes the cost of health care services, medications to treat high blood pressure, and missed days of work (AHA, 2017)
Chronic Kidney Disease – CKD
The Facts About Chronic Kidney Disease (CKD)
30 million American adults have CKD and millions of others are at increased risk.
Early detection can help prevent the progression of kidney disease to kidney failure.
Heart disease is the major cause of death for all people with CKD.
Glomerular filtration rate (GFR) is the best estimate of kidney function.
Hypertension causes CKD and CKD causes hypertension.
Persistent proteinuria (protein in the urine) means CKD is present.
High risk groups include those with diabetes, hypertension and family history of kidney failure.
African Americans, Hispanics, Pacific Islanders, American Indians and Seniors are at increased risk.
Two simple tests can detect CKD: blood pressure, urine albumin and serum creatinine
NKF 2018
Reading assignments:
Read the following articles
Public Health and Chronic Disease Cost Savings and Return on Investment https://www.apha.org
Multiple Chronic Conditions Among U.S. Adults: A 2012 Update. https://dx.doi.org/10.5888/pcdh.130389
The Chronic Care Model http://www.improvingchroniccare.org/index.php?p=Model_Elements&s=18
American Diabetes Association ADA https://www.diabetes.org
Review the websites: Browse through the topics
Nation Diabetes Statistics Report 2020
https://www.cdc.gov/diabetes/data/statistics-report/index.html
Hypertension Facts https://www.cdc.gov/bloodpressure/facts.htm
American Heart Association https://www.heart.org
Review the web site and the sections on Hypertension and Nephrology, High Blood Pressure or Hypertension, New 2017 AHA/ACC Hypertension Guidelines
National Kidney Foundation – Review the web site http://www.kidney.org/
National Kidney Disease Education Program – Review the website http://www.nkdep.mih.gov/
American Kidney Health: 2020 Report
https://aspe.hhs.gov/system/files/pdf/263921/advancing-american-kidney-health-progress-report.pdf
Discussion Questions: Answer the Discussion Questions, use your reading assignments as references.
Then make 2 Peer Reponses, no short responses
What are some similarities in people with diabetes and hypertension?
Describe a self-care activity for chronic disease management.
How does a person with multiple chronic disease states impact the health care system?
What are the treatment options for kidney failure?[supanova_question]