Study "Disease / Virus / Disorder / Injury" Essays 991-1000

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Evidence-Based Practice Project a Literature Term Paper

… This demonstrates the effectiveness of influenza vaccination for elderly people.

The evidence presented by the researchers is strong and clear indication is offered on how to prevent the development of pneumonia there is need to offer yearly vaccinations. The study results might not be applicable to Veterans Affairs facilities (Loeb et al., 1999). The study found that the development of pneumonia does not result in decline in functional status as had earlier been shown. This is a good study that would offer positive grounds for advancement of this research. The researchers noted that viral respiratory infections were common, and this mostly lead to development of pneumonia in the elderly. The unavailability of previous research focusing on this phenomenon makes it hard to establish if this finding is correct. Future research could assist in determination of the same.

This is a position paper that addresses all levels long-term care facilities. This article offers recommendations for providing infection control to long-term care facilities. The authors have focused on a variety of infections, and their main intention is to minimize health care associated infections. These infections have been identified as preventable, and health care administrators should ensure their facilities reduce such infections. As with the other articles, the author has focused on pneumonia and respiratory tract infections that occur in hospital settings. These infections are mostly associated with procedures that patients undergo. The measures proposed are not proven by any research study, but they are based on basic infection control logic (Smith et al., 2008). The authors focused on elderly persons aged above 65 years. It was found that there are 1.8 to 13.5 endemic infections occurring for every 1000 residents in care facilities (Smith et al., 2008).

The wide range of infections demonstrates the difficulty faced in trying to determine the epidemiology of the infections. The impact such infections would have on individuals is also hard to establish. Hand washing has been established as a contributor to the spread of infections, since some of the elderly are least likely to wash hands or maintain proper personal hygiene. The article does demonstrate the need to have proper care especially to elderly persons living in care facilities. This is vital, as it would ensure the patients are not infected with preventable diseases. These diseases have been proven life threatening since the patients are frail and their immune systems weak. The leading cause of death in LTCFs is pneumonia (Smith et al., 2008). The article has covered all areas of infection, which has made the information provide quite relevant and applicable to the current situations.

References

Loeb, M., McGeer, A., McArthur, M., Walter, S., & Simor, A.E. (1999). Risk factors for pneumonia and other lower respiratory tract infections in elderly residents of long-term care facilities. Archives of internal medicine, 159(17), 2058-2064.

Rabie, T., & Curtis, V. (2006). Handwashing and risk of respiratory infections: a quantitative systematic review. Tropical medicine & international health, 11(3), 258-267.

Smith, P.W., Bennett, G., Bradley,… [read more]


Objective Article Review

… " (Centers for Disease Control and Prevention, 2014, p. 8)

II. Choosing PPE

There are three primary considerations for the choice of personal protective equipment including: (1) the anticipated exposure; (2) durability and appropriateness of PPE for the task; and (3) fit. (Centers for Disease Control and Prevention, 2014, p. 39)

III. PPE for Standard Precautions

It is reported that Personal Protective Equipment for Standard Precautions includes:

(1) Gloves -- for use when touching "blood, body fluids, secretions, excretions, contaminated items; for touching mucus membranes and nonintact skin (Centers for Disease Control and Prevention, 2014, p. 39)

(2) Gowns -- for use during "Procedures and patient care activities when contact of clothing/exposed skin with bloody/body fluids, secretions, or excretions is anticipated." (Centers for Disease Control and Prevention, 2014, p. 39)

(3) Mask and goggles or a face shield -- of use during "patient care activities likely to generate splashes or sprays of blood, body fluids, secretions or excretions" (Centers for Disease Control and Prevention, 2014, p. 39)

Summary and Conclusion

The article reviewed in this study published by the (Centers for Disease Control and Prevention (2014) has informed this study as to the proper use of personal protective equipment in the healthcare environment.

References

Guidance for the Selection and Use… [read more]


Toxicology After Taking the Position Case Study

… Elimination

The main way of excretion is by means of urine elimination. However, other studies that have been done in volunteers made the point that 15-17% elimination of the compound was looked at as being the stable rate after an originally high excretion amount. That removal of 13-16% stayed at being stable for beyond a year. Also, another understood direction of elimination is by way of the feces, even though there has not been much little indication has shown this to be important (it is still looked at as being a route of elimination for the reason that if DDT metabolites are present in feces, they would exist in that it is an untraceable conjugates).

3. What types of exposure and response are associated with DDT?

When it comes to DDT, Human exposure has been linked with many malignant effects. Research shows that higher liver cancer rates were discovered in communities that have a much higher DDT concentrations in fat tissue. Pancreatic cancer is also connected with chronic DDT exposure.

Further investigation also shows that Cancer is not the single health risk linked with chronic high-level contact to DDT. Employee's unprotected to high concentrations of DDT in the place of work were suggested in a 2006 report to be at a risk that is higher for diabetes. There are other studies which have discovered dose-linked increases in the risk of increasing diabetes with DDT contact.

Research shows that the biggest indication for ill effect of DDT contact is not discovered in adult diseases. Developmental outcomes are some of the most deeply concerned dangers from DDT. However, at the fetal stage, offspring whose mothers have a very high level of serum DDT metabolites were at bigger danger for spontaneous abortion and death. Preterm delivery was likewise discovered to be elevated in a manner that concurred with raised serum DDT stages. It would also need to be noted that these effects were looked at right away after the 1960s age of extremely high environmental usage of DDT in America, and far along studies where women with lesser serum levels of DDT displayed that low-level contact to DDT does not appear to connect with other gestational defects or even preterm birth.

4. Should the WHO continue to approve the use of DDT to combat malaria?

Not that long ago, the World Health Organization today publicized a most important change in policy. It appears that the WHO is in the process of aggressively supporting the debated insect killer DDT as a means of trying to keep malaria up under tight control. It is obvious that the WHO has some understanding that Malaria kills about 1 million individuals a year, mostly children, and mostly in Africa, in spite of a decades-long effort to eliminate it. With that being said, the WHO should not continue with approving the use of DDT to get rid of Malaria.

References

The use of DDT in malaria vector control. (2011, August 21). THE USE OF… [read more]


Discharge Plan for an Asthmatic Child Term Paper

… , CCHMC).

In combination, the boy will be given 2-6 inhalations of beta2 agonists at 20-minute intervals and then re-evaluated (CCHMC, 2010). A hand-held metered dose with a spacer device may be used on the child. The aim is to correct severe hypoxemia, quickly reverse airflow obstruction and minimize the risk of relapse. Inhaled corticosteroids have proven effective in managing persistent asthma (Kovesi et al., 2010). They will be given to the boy every day and between exacerbations as a minimum regimen for a given duration at four puffs per dose in children one year and older. Home-made spacers may also be used as effective substitutes. These include plastic bottles, foam or paper cups, cardboard tubes or paper spacers. Their effectiveness has been beyond question when used correctly and adequately, so that in case of failure, a diagnosis of asthma or another illness should be reconsidered. In cases when the control of symptoms remains inadequate with the application of moderate dose of inhaled corticosteroids, the dose should be increased or a receptor antagonist introduced. Should he need additional therapy, a pediatric asthma specialist will be consulted (Kovesi et al.).

Inhaled steroids must be regularly administered for a given duration and not only during attacks in order to be effective (Koversi et al., 2010). The combination will improve lung function, resulting in reduced hospitalization. Inflammation tends to persist for many days following an acute attack. Intensive therapy is, therefore, necessary after discharge until symptoms resolve and peak expiratory flow normalizes (Kovesi et al.).

BIBLIOGRAPHY

AsthmaCure (2010). Some facts and statistics about asthma. AsthmaCure.com.

Retrieved on July 20, 2014 from http://www.asthmacure.com/2010/12/asthma-facts-statistics

CCHMC (2010). Management of acute exacerbation of asthma in children. Health Policy & Effectiveness Program Evidence-Based Guideline. Retrieved on July 20, 2014 from http://www.cincinnatichidrens.org/workarea/downloadAsset%3Fid%3D87871

Kovesi, T., et al. (2010). Achieving control of asthma in pre-schoolers. Canadian Medical

Association Journal: Canadian Medical Association. Retrieved on July 20, 2014 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2831671

Pollart, S., et al. (2011). Management of acute asthma exacerbations. Vol. 84 # 1,

American Family Physician: American Academy of Family… [read more]


Anemia Through Blood Loss Case Study

… If this diagnosis is correct, then some of the steps that need to be taken should be taken right away. Since there are no signs that there was a large loss of blood; but that the blood the patient has been losing has essentially been over the long-term, then a blood transfusion may not be necessary. If there were signs of a large loss of blood, then a blood transfusion could be a medical necessity. Oxygen, fluids and possibly even iron should be given to the patient while still at medical facility. One recent study determined that "intravenous iron may help to alleviate symptoms in patients" (Kansagara, Dyer, Englander, Rongwei, Freeman, Kagen, 2013, p. 746) but in this particular case it would likely be better to provide the patient with iron supplements.

The more pressing issue of course, is to address the loss of blood, and how to control the underlying cause of the anemia. In this case, Ms. A is experiencing menorrhagia, and that could be the exacerbation that is leading to anemia. The molecular structure of the blood cells (see blood results) show that the patient is presenting with symptoms of blood loss anemia and that replacing the iron and building new red blood cells is of major importance. The results also show that the ongoing chronic loss of blood must be addressed as well.

This might be best accomplished by providing the patient with information concerning the disease, and by follow-up appointments to ensure that the patient is attending to her anemia in an appropriate manner.

Works Cited

Ford, J.; (2013) Red blood cell morphology, International Journal of Laboratory Hematology, Vol. 35, Issue 3, pp. 351 -- 357

Kansagara, D.; Dyer, E.; Englander, H.; Rongwei, F.; Freeman, M.; Kagen, D.; (2013) Treatment of anemia in patients with heart disease, Annals of Internal Medicine, Vol. 159, Issue 11, pp. 746 --… [read more]


Globalization the Country Case Study

… It is invaluable to send those patients who are from the areas in which the confirmed cases of cholera are from for treatment first, because they have a greater propensity for having contracted this disease.

The health/environmental problem I would attempt to handle early in my work is the process of administering vaccinations, which is perhaps the swiftest way to reduce the incidence of additional cholera cases. It might be difficult to attain the resources to significantly change the sanitary and hygienic conditions responsible for this epidemic in a short amount of time, but it certainly is possible to vaccinate people in this time frame. Despite the limited resources, one of the most powerful things the nurses and I can do to engender infection control is to educate our patients about the necessity of hygiene, sanitation, and accessing clean water and clean food. These patients need to learn how to properly prepare food in the wake of a cholera outbreak in a matter that is sanitary and hygienic, such as eating raw foods after they have been washed in clean water, covering food, and washing their hands before eating (Thabo, 2014). In terms of standard precautions, it is necessary that the nurses working in the shelter and that the shelter itself has all of the resources to provide a sanitary, hygienic environment -- both for the workers and their patients.

While I work with the physicians with the sickest of the patients, one of the primary responsibilities that I could designate to others includes educating the masses about the particulars of this disease. Doing so not only includes telling them what cholera is, but also how it is contracted and, most importantly, all of the things they can do to prevent it from spreading. Nurses who are not working with the most sick patients should have this responsibility because it is still extremely valuable and is a service that is less demanding that working with the aforementioned patients. Another aspect of patient care that could be assigned to other nurses is ensuring that supplies are coming in from the Ministry of Health and its affiliates. Again, this is an extremely important responsibility which is not technical in nature, which is wise less experienced nurses can be trusted with it. Although it might be possible to bring some supplies with my team of nurses from the U.S. (such as certain prepackaged cholera testing measures), the bulk of our supplies for providing proper environments related to sanitation, hygiene and clean water should come from the Ministry of Health, and its partnerships with other organizations such as the World Health Organization.

References

Centers for Disease Control and Prevention. (2013). Cholera -- Vibrio cholerae infection. www.cdc.gov. Retrieved from http://www.cdc.gov/cholera/diagnosis.html

Thabo, O. (2014). Cholera outbreak in Juba, Republic of South Sudan. www.who.int. Retrieved from http://www.who.int/hac/en/

World Health Organization. (2014). Cholera outbreak in Juba, central equatorial state. search.who.int / Retrieved from http://search.who.int/search?q=health+crises+2013&ie=utf8&site=who&client=_en_r&proxystylesheet=_en_r&output=xml_no_dtd&oe=utf8&getfields=doctype [read more]


Diabetes / Brian Cancer Essay

… 1. The functional regions of Monique's cerebral cortex that are likely to be affected by the brain tumor are the ones which receive the pressure from the growth of the tumor: these would be the right occipital and temporal lobes.

2. The location of Monique's brain tumor between her right occipital and temporal lobes is most likely immediately to affect vision, which is governed by the occipital lobe, and hearing and memory, which are governed by the temporal lobe. Thus doctors would be on the lookout for visual or auditory impairment or hallucinations, and also memory loss or linguistic impairment as well.

3. The reason why chemotherapy might potentially be able to affect a lung tumor but not a brain tumor is due to the blood-brain barrier. This barrier was a relatively recent scientific discovery. Interlandi (2013) notes that it was actually discovered by Paul Ehrlich (subject of the Hollywood biopic "Doctor Ehrlich's Magic Bullets"), who would go on to develop arsphenamine, the first effective cure for syphilis but also (not coincidentally) the first modern chemotherapy drug (52). Ehrlich discovered that specimens whose bloodstream was injected with a staining dye would exhibit coloration everywhere but the brain, while specimens injected directly into the brain would exhibit consistent coloration within the brain but nowhere else. Ultimately it was established that the blood vessels in the brain are lined with endothelial cells that are so tightly packed together that very few substances can pass through. Chemotherapy drugs, which are generally large molecules, are unable to get through the blood-brain barrier.

4. Glioblastoma multiforme is a type of brain cancer that can take on different forms (hence "multiforme"): gliosarcoma or giant cell glioblastoma. It is the most common form of malignant brain tumor affecting adults, and offers a poor prognosis for most patients. The tumors like Monique's that are caused by glioblastoma multiforme generally display characteristic genetic mutations which are presumably related to the aggressive growth of the cancer: these mutations affect the genes for epidermal growth factor receptor (EGFR), a gene for a tumor-suppressing protein (TP53), the gene for platelet-derived growth factor receptor (PDGFR), and the gene for synthesizing isocitrite dehydrogenase (IDHI). Other genes with involved mutations include one that produces enzymes for maintaining proper DNA protection (TERT) and a genetic mutation otherwise associated with the disease neurofibromatosis (NF1).

References

Ahmed, AM. (2002). History… [read more]


Health Fair Presentation on Diabetes Research Paper

… What is your waist circumference measured below the ribs?

Less than 94cm

94-102 cm

More than 102cm

5. Do you engage in regular physical activity for at least 30 minutes every day?

Yes

No

6. How often do you consume… [read more]


Biological, Psychological, and Social Determinants of Health Case Study

… 574-575). Morrie has been quite successful in this regard, even to the point documenting his demise with former student Mitch Albom. According to Peck, successful aging requires three adjustments. The first adjustment is from the role of wage-earner to retiree, which Morrie successfully managed by grieving the loss of his old role as teacher and establishing a mentoring role with Albom. Morrie has also accepted the fact that he is gradually losing his ability to walk, write, or even hold lengthy conversations and has transcended these limitations by remaining intellectually involved on micro and mezzo levels. The third adjustment necessary for successful aging is self-transcendence, which Morrie accomplished by shifting his attention away from self-pity by sharing his death with loved ones. If the psychological items on the INTERMED instrument were used to evaluate Morrie, he would score very low on all items (Mazzocato et al., 2000; INTERMED Foundation, 2009). Psychologically, Morrie is doing very well.

Sociological

On a micro level, Morrie appears to be an outgoing, gregarious, and good-humored individual who has remained intellectually sharp and active (Albom, 1997); therefore, Morrie does not have any impairment that would prevent social interactions. On a mezzo level, Morrie is loved and cared for by family, friends, former students, and former colleagues (Ogden and Jackson, 1999). Compared to other patients in palliative care, patients with ALS tend to be less of a burden on caregivers; however, with increased symptom severity and behavioral problems the burden can become significant enough to threaten the psychological health of caregivers (Hecht et al., 2003). Morrie's caregivers do not appear to be at risk due to the large number of people, informal and professional, involved in his care. Should this change as Morrie nears the end of his life, additional support could be obtained on a macro level from the U.S. healthcare system. Based on this assessment, Morrie would score very low on the INTERMED social items (Mazzocato et al., 2000; INTERMED Foundation, 2009).

Conclusions

From a biopsychosocial perspective, the greatest threat to Morrie's health is physiological. This is due to the rapid progression expected for an ALS patient of his age and the imminent threat of death. Psychologically and socially, Morrie is aging successfully despite the ALS.

References

Albom, M. (1997). Tuesdays with Morrie: An Old Man, a Young Man, and Life's Greatest Lesson. New York: Doubleday.

Foley, G., Timonen, V., & Hardiman, O. (2014). Acceptance and decision making in amyotrophic lateral sclerosis from a life-course perspective. Qualitative Health Research, 24(1), 67-77.

Hecht, M.J., Graesel, E., Tigges, S., Hillemacher, T., Winterholler, M., Hilz, M.J. et al. (2003). Burden of care in amyotrophic lateral sclerosis. Palliative Medicine, 17(4), 327-33.

INTERMED Foundation (2009). The INTERMED Method: INTERMED Complexity Assessment Grid (IM CAG version 6). Retrieved 28 Apr. 2014 from https://www.intermedfoundation.org/uploads/10/32/103299ff97ac58bcee216085ec23a708/Description-of-IM-CAG-v6-including-interview-and-score-December-2009.pdf.

Mazzocato, C., Stiefel, F., de Jonge, P., Levorato, A., Ducret, S., & Huyse, F.J. (2000). Comprehensive assessment of patients in palliative care: A descriptive study utilizing the INTERMED. Journal of Pain and Symptoms Management, 19(2), 83-90.

Mitsumoto, H.… [read more]


Polycystic Ovary Syndrome, Renal Calculus Essay

… ¶ … PCOS, Kidney Stones)

DuRant and Leslie provide a basic overview of all known facts concerning the condition known as polycystic ovary syndrome. While this is the most widespread endocrine condition to affect young women (estimates place its incidence at between 5 and 10% of the young female population) it is frequently not diagnosed. The basic diagnostic criteria are indeed somewhat contentious, and presently a diagnosis hinges upon the presence of two of the following three symptoms: irregularities in ovulation (either failure to ovulate or irregular or lengthened menstrual cycle, i.e., oligoovulation), a raised level of male hormones with no other cause, and polycystic ovaries with no other cause. Each of these individual symptoms can, of course, be caused by other conditions, but the presence of two of them with any other conditions (i.e., adrenal tumor) ruled out indicates polycystic ovary syndrome. As the descriptor "syndrome" should indicate, the cause of polycystic ovary syndrome is presently not understood. The consensus is that it involves some defect in the endocrine processes that govern ovulation, in which the hypothalamus and pituitary in the brain communicate chemically with the ovaries to trigger ovulation. The syndrome generally accompanies onset of menarche at age 12 or 13: young women who have polycystic ovary syndrome generally never develop a consistent schedule of menstruation. Other symptoms include those generally associated with heightened androgen levels, including male facial hair, male pattern baldness, and acne. Half of women with polycystic ovary syndrome are obese. However the chief clinical sign is endocrine, indicated by a heightened level of luteinizing hormone and follicle stimulating hormone in the ratio of 2:1 or higher. This heightened hormonal ratio is present in 60 to 70% of patients with the syndrome, and more likely to occur in those who are not obese. Weight control and oral contraceptives (to counteract increased androgens) can alleviate some of the symptoms, but polycystic ovary syndrome correlates to other illnesses later in life like diabetes mellitus, hyperlipidemia, endometrial cancer, and infertility, and thus should be treated as a potential risk factor for these later conditions. In particular, polycystic ovary syndrome is more common in patients who have a prevalence of type 2 diabetes on both sides of the family.… [read more]


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