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Alternative Treatments: Acupuncture for Pain Term Paper

… Different types of acupuncture are available at this center. Chinese Acupuncture is the most common method, and it is considered to be a traditional method. It is used for all kinds of pain as well as for orthopedic conditions. Japanese Acupuncture, which focuses on the entire body and is said to be a gentler form of treatment, is growing in popularity. Other therapies are available as well. Cupping, for example is used for easing sore muscles; instead of needles, glass cups are applied to the skin and suction is used to remove blocked energy. Another type of treatment is Moxa Therapy, which uses herbs. Auricular therapy focuses on the ears as the treatment point; in this type of therapy, the ear is viewed as a microsystem for the body. It is commonly used for assistance with smoking cessation or for relaxation. Reiki is also becoming increasingly popular to help restore the body's qi from built-up stress and other energy blockages.

The rates at the center are more reasonable than most. An acupuncture visit is $70.00, although there are special rates available for students, elderly and unemployed ($45.00). The center also offers to match any discount your insurance company may offer by up to 25%. For individuals who do not have insurance, there is a sliding fee scale that is based on yearly income. According to this scale, for example, an individual with an income above $50,000 will be charged $70.00 per session, while an individual whose income is below $20,000 will be charged $50.00.

I would absolutely recommend this acupuncture center to friends and family. The entire experience felt therapeutic. It did not have the feel of a medical office, which is something that can cause tension in itself for me. The staff members were welcoming and made me feel comfortable and at home, offering refreshments (water, herbal tea), and taking the time to explain types of treatment as well as payment plans. This was done very discreetly and in a direct and clear manner. I would also strongly recommend this type of therapy to anyone who was in pain, not just as an alternative to traditional medicine, but as an initial treatment plan. Traditional medical treatments can be invasive and costly. Use of medication can have a number of unpleasant side effects that may be just as harmful as the original pain was. Surgery is invasive and requires time off of work and a disruption of one's daily activities, and there is no guarantee of pain cessation.

References

Acupuncture (2012). The Mayo Clinic. Retrieved electronically on May 6, 2012 from http://www.mayoclinic.com/health/AboutThisSite/AM00057

Koopsen, C. & Young, C. (2009). Integrative health: A holistic approach for health professionals. Sudbury: Jones and Bartlett.

Tran, A. Acupuncture alternative (2012). Markula Center for Applied Ethics, Santa Clara

University, CA. Retrieved electronically on May 6, 2012 from http://www.scu.edu/ethics/dialogue/candc/cases/acupuncture.html

Two views of acupuncture. (2011). Retrieved electronically on May 6, 2012 from http://www.two-views.com/Acupuncture/What.html… [read more]


Medication Changes With Technology Term Paper

… This would entail CPOE to be linked to a comprehensive electronic medical record whilst nurses would administer the medications with smart pumps that would be reinforced with bar code point-of-care units that punctiliously contain all details of the patient's treatment. Spurlock et al. (2003) see this ideal system as ranging far ahead in the future.

However useful these technologies -- and they certainly are so - hospital and medical institutions can only benefit from them when skilled professionals employ them. And used carefully.

References

Spurlock, B. et al. (2003) Legislating Medication Safety: The California Experience. Convergence Health Consulting.

http://www.premierinc.com/quality-safety/tools-services/safety/safety-share/12-03-downloads/04-CA-med-safety-tech-legislation.pdf

Health Information Technology (2009) Electronic medication administration records improved communication and decision-making in nursing homes http://www.ahrq.gov/research/jul09/0709RA29.htm

Institute of Medicine (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. The National Academies Press. http://www.nap.edu/books/0309072808/html.

The Institute of Medicine (2006). Preventing Medication Errors. The National Academies Press. http://www.nap.edu/catalog/11623.html.

Kaufman, M. (2009) New IV smart pump technologies prevent medication errors, ADRs

Formulary Enews

http://formularyjournal.modernmedicine.com/formulary/Technology+News/New-IV-smart-pump-technologies-prevent-medication-/ArticleStandard/Article/detail/611706

Santell, John P (2004). Computer Related Errors: What Every Pharmacist Should Know (PDF). United States Pharmacopia. http://www.usp.org/pdf/EN/patientSafety/slideShows2004-12-09.pdf.

Yong Y. Han, Joseph A. Carcillo, Shekhar T. Venkataraman, Robert S.B. Clark, R. Scott Watson, Trung C. Nguyen, Hulya Bayir, and Richard A. Orr (2005). Unexpected Increased Mortality After Implementation of a Commercially Sold Computerized Physician Order Entry System. Pediatrics 116 (6): 1506 -- 1512.… [read more]


Admission for Doctor of Naturopathic Medicine Program Thesis

… Admission for Doctor of Naturopathic Medicine Program

APP: Admission for Doctor of Naturopathic Medicine Program

A number of years ago, whenever I or any of my siblings developed a cold, my mother would simply say, "there is no need of taking any medication for that…. you will shrug it off in a week or so." We may not have understood what she meant then (there was no explanation given) though her concept seemed to work most of the time. It was not until much later that I came to learn that the human body possesses an innate ability to heal itself and hence effectively, my mother was simply citing that fact. Perhaps it was this discovery that informed my keen interest on this simple concept which largely serves as the foundation for naturopathic medicine.

As a potential student for Doctor of Naturopathic Medicine Program, I am convinced I have my priorities right based on the interest I have developed over time in the field of naturopathy. I am certain that should I be allowed to pursue the Program; I will not only have an opportunity to quench my thirst for knowledge in regard to the body's ability to combat disease but I will also have a rare chance to make a lasting contribution towards the advancement of alternative remedies in a way that benefits mankind.

In my opinion, the opportunity to pursue the Doctor of Naturopathic Medicine Program at a state-of-the-art institution will give me another rare chance to learn from some of the best minds in Naturopathic Medicine. Further, I would like to pursue the Program in a facility with an enriched study environment and a diverse student community. Your facility fits the bill. The enriched study environment and diverse student community at your institution will give me yet another rare opportunity to enhance my communication and…… [read more]


Cam Therapeutic Modalities Term Paper

… Alternative medicine is any medicine that is contrary to evidence-based medicine usually initiating from a historical or cultural, rather than evidence-based or scientific, background. Examples include Reiki, yoga, meditation, naturopathy, chiropractice, Ayurveda, acupuncture, biofeedback, hypnosis, homeopathy, nutritional-based practices and many other healing methods, some more controversial than others. Complementary medicine (CAM) refers to the integration of one or more approaches of alternative therapy with conventional medicine. Integrative medicine (IM), the goal being to treat mind, body, and person concurrently, focuses on treating the person not the disease and uses alternative medicine to do so. It is synonymous to CAM, but, perhaps, exceeds that by referring to the healthcare system as a whole and ensures that the approaches used are safe and effective.

Whilst CAM and IM may differ from conventional medicine in being holistic, individual centered and focusing on a spiritual approach often lacking evidence background, they are increasingly starting to adopt the conventional scientific method of testing their approach, aside from which conventional medicine (otherwise called allopathic or orthodox) is part of their structure.

The philosophy of CAM is preventative and holistic in that it aims to address all components of the person: emotional, physical, and mental. In this way, it is different to conventional Western medicine that focuses on healing (rather than preventing) and is purely physically oriented.

CAM therapies may be categorized into five major fields: mind-body interventions, movement therapies, manipulative and body-based methods, biologically based approaches, and energy therapies.

Biologically-based medicine would include what the NIH refers to as its natural approach where a variety of herbal products (also called "botanical"), vitamins, minerals, and "natural products" are supplemented to one's nutrition in order to boost health. CAM "natural products" also include a focus on probiotics (live microorganisms) found, for instance, in yogurt, echinacea, and fish oil / Omega 3.

Mind-body interventions maintains that mind and body are intricately linked in affecting physical functioning. CAM, therefore, often uses mind to heal the body. Some of the approaches reflecting this are: meditation (which via focused mental attention increases calmness), yoga (which via specific poses and mindfulness decreases stress and promotes relaxation), and acupuncture (that stimulates specific points on the body such as with needles; these areas are then electrically stimulated or massaged by hand). Other mind body modalities include deep breathing, visualization, guided imagery, hypnotherapy, tai chi, and qi gong.

Manipulative and body-based practices involve manipulating the structures and systems of the body such as the bones and joints, soft tissues, and circulatory and lymphatic systems. Two common therapies within this category are message therapy and spinal manipulation. The former involves massaging muscles and other soft tissues of the body. Its purpose includes to relive pain and stress and to enhance general…… [read more]


History of Folk Medicine Essay

… Life before Tylenol and Prozac: A History of Folk Medicine

Brief Course Description

This course will provide an overview of the history of folk medicine from the earliest civilizations to modern times. Topics covered will include: Religious aspects of folk… [read more]


Psychotropic Medicines Are Often Prescribed to Individuals Research Proposal

… Psychotropic medicines are often prescribed to individuals with developmental disabilities although the reason for this is not clear in many instances. The aim of the study proposed herein this document is to assist the Department on Disability in reviewing and… [read more]


Medicine in Colonial America Term Paper

… Medicine in Colonial America

The period we can call Colonial America can be the period from 1497 to 1776. The examination of medical practices during the period, first with the original natives of the land, and then the medical practices… [read more]


Cranberries as an Alternative Medicine Term Paper

… cranberries (Vaccinium macrocarpon) are indigenous to North America and have been used in traditional Native American medicine for centuries if not millennia. Related to blueberries and rhododendrons, the North American cranberry is a bog fruit commonly used as a culinary… [read more]


Consent in Cam Consent and Herbal Medicine Term Paper

… ¶ … Consent in CAM

Consent and Herbal Medicine: A Literature Review

The topic of informed consent is important for any portion of the legal profession. Informed consent assures that patients remain an integral part of the decision-making process. The… [read more]


Medieval Techniques of Healing Term Paper

… Medieval Medicine

Many people mistakenly assume that little progress was made in the sciences during the Medieval era. Techniques of healing may have seemed crude and often associated with a connection between faith and the body the "science" or professionalism… [read more]


Interpersonal and Communication Skills Admission Essay

… ¶ … interpersonal and communication skills are two of the essential characteristics of any compassionate pharmacist. A pharmacist is not a mere dispense of medication. He or she is a scientist by training, but part of his or her job is to enable the layperson to understand how to administer medication correctly, with the correct dosage, at the correct time. A vigilant pharmacist checks and double-checks the patient's prescribed list of drugs, for contraindications, reminds the patient which drugs are not to be taken with alcohol or before driving, and can calm down a worried mother or a confused elderly person, so the individual can listen clearly to advice.

I know the importance of communication all too well, because of my own past. I came to Iran after graduating as the valedictorian of my high school. However, because of the challenging courses in college I took my freshman year to prepare myself for my…… [read more]


Medical Anthropology Term Paper

… Alternative Medicine

Complementary and Alternative Medicine

Altshuler, Larry

2004 Balanced Healing: Combining Modern Medicine & Safe & Effective Alternative Therapies. Gig Harbor, WA: Harbor Press.

A reference guide for anyone who wants to benefit from alternative healing methods, without replacing… [read more]


Attending the Lecom School of Pharmacy Admission Essay

… ¶ … attending the LECOM School of Pharmacy because of the unique opportunities offered by the school. As a retail pharmacy technician, I have seen how important it is for pharmacists to work with patients, because many patients have multiple doctors and have not provided those doctors with complete medical histories. Therefore, pharmacists may be the only medical providers aware of possible medical interactions or other pharmaceutical contraindications, and cannot be relegated to the role of medication providers. LECOM has a reputation of teaching pharmacists how to take an active role in patient care by being actively involved in disease management, behavior modification, and drug therapy; and I believe that philosophy is one that all pharmacists should embrace.

To me, professionalism means retaining the ability to do one's job regardless of the emotional or situational context of the situation. I believe that the concept of professionalism is especially important for pharmacists, because there are some medications that many pharmacists find morally objectionable. However, professionalism means that one does not impart value judgments…… [read more]


Moral Dilemma Harvey's Wife Suffers Term Paper

… Moral Dilemma

Harvey's wife suffers from a deadly disease and if she does not take her prescribed medication soon she will surely die. The only way Harvey can obtain the medication is by stealing it from the pharmacy because he cannot afford to pay for it himself and no one is willing to help him. Harvey's story raises a host of moral dilemmas. First, the medical system is itself immoral because it is based on financial class rather than on humanitarian need. Second, the impetus to help others should prevail over profit and even the pharmacy might have a moral obligation to help Harvey's wife. Harvey has a moral obligation to help his wife. Third, Harvey breaks a law and a moral code by stealing but to do so he fulfills a much higher duty: to save his wife's life at the expense of no one else's.

If Harvey steals the medication from the pharmacy he does not hurt…… [read more]


Admissions First Laid Eyes on the Physician Essay

… admissions first laid eyes on the Physician's Desk Reference when I volunteered at a pharmacy in Iran when I was in high school there. Although I was born in Norfolk, Virginia, my family and I moved to Iran when I… [read more]


Third Class of Drugs Term Paper

… Pharmacists therefore note that consumers would save enormous amounts of money with a third class of drugs: "Granting pharmacists control over a specific group of prescription medications might serve to improve care in a cost-effective manner," (Labbe). Many patients can… [read more]


Statement of Goal Term Paper

… Proudly clutching my shiny new degree, I stared at the faces in the crowd. Although the audience at the graduation ceremony in May was loud with their clapping hands and whistling, I suddenly became besieged by silence. Looking for a familiar face to stabilize me, I instantly knew the source of my panic attack. For years I had pursued a degree in business because as an international student, I felt it would offer me the best opportunities for advancement and for networking with people in my new surroundings. Furthermore, business degrees apply to a wide range of industries and I knew that with a little experience and a lot of soul-searching that I would eventually discover a path on which I could tread joyfully. A few of my internships broadened my horizons but until recently I had not found my calling. My friend came over to me and said, "What's wrong?" I replied, "What am I going to do now?"

She laughed. My undergraduate career was enriching, as I overcame a slew of obstacles living and studying amid people who spoke different languages and who ate different foods. Like many of my classmates, now was the moment of reckoning: we were walking the plank when we stepped off of that stage. It was time to plunge into the real world.

A realized that my business degree wasn't an automatic ticket to self-fulfillment long ago. However, as I stood starkly on that stage I knew that I would have to apply my newfound skills through career development. Quite by accident, I came across a job opening in an oncology specialist's office. Having a keen interest in medicine but little confidence in my ability to pursue a medical career, I applied for the position and was soon working as an office assistant.

My job instantly sparked in me a passion for health care. When…… [read more]


Drugs and Human Health Term Paper

… Pharmacy

Patients in life or death situations often can not swallow and also drugs given intravenously often act more rapidly, and some drugs are or can be destroyed by gastric acids.

Nitroglycerin tablets are given sublingually because the blood under… [read more]


Forbes Magazine Entitled Term Paper

… (Lambert) Still others argue that receiving prescriptions by mail is more cost effective for customers.

Finally, the article explains that Walgreen's and other drug stores have decided to take a firm stand against PBM's and mail order prescriptions. The article asserts that Walgreen's is now "blacklisting customers whose health plans force them to use mail for long-term drugs but steer them to stores for the one-time drugs. That is, it will to accept insurance cards as payments for one-time orders from these patients."(Lambert)

Opposing Views/Opinion

The issue of PBM's and mail order prescription is certain to be an issue for years to some. The drugstores and pharmacies fear that the mail order prescription business will be detrimental to their survival. They seem to believe that PBM's are only on the side of the drug company and that they are lying to consumers. The drugstores believe that mail order prescriptions are not cost effective while the PBM's argue that consumers can save up to 27% if they order their prescriptions through the mail

At the other end of the debate there are consumers who like to order their prescriptions through the mail. Some consumers do this even if it is not mandated by their insurance providers. In many cases consumers just find it more convenient to order prescriptions through the mail. In any case, the PBM's and the drugstores will continue to quarrel over which method is less expensive.

In my own opinion, it seems that Walgreen's should not have the right or ability to blacklist customers because of the decisions that are made by their healthcare providers. In many cases people are in dire need of receiving their medication and may not have time to ride around to different pharmacies just to get a prescription fulfilled. It is apparent to me that all Walgreen's is concerned with is its bottom line and they are willing to sacrifice the health of customers just to prove a point to PBM's. The fact of the matter is that consumers have a right to purchase prescriptions in any way that they see fit. Some people prefer going to a traditional pharmacists, while other prefer for the prescriptions to be brought to their homes. Walgreen's has to be careful not to ignore the needs and desires of consumers in the quest for…… [read more]


Medicine and Culture Payer, Lynn Term Paper

… This observation is extended by Payer to include medical training and the general population within each country. Therefore the book emphasizes the differences, not only between the medical staff, but also between the patients of each country.

Medicine & Culture's primary argument is directed at American doctors and patients, and their general tendency to regard their country's medicine as the most scientifically correct manner in which to diagnose and treat disease. Payer suggests that the American medical profession, and the public, should adopt a wider perspective and consider the way in which their country's medical practices are established and influenced by historical traditions and cultural biases. By devoting a seperate chapter to each of the four central countries, Payer's expands upon her theories and ideas, and examnines specific medical conditions and the manner in which the doctors of each country approach the areas of diagnosis and treatment.

Considering the rapid advances made in recent years, within the field of medicine, it is likely that many of the claims and conclusions made by Payer will now be out of date. However, the central message remains as valid and thought-provoking today as it did back in 1985. It is important for doctors, and patients, to avoid taking a narrow, cultural specific view of disease, diagnosis, and treatment. As everyone's lives become increasingly influenced by globalization and multiculturalism, Payer's message is that the medical profession of each country should continually look beyond the limitations and accepted truths of its own culture, and keep its mind open to the ideas and theories of…… [read more]


Holistic Medicine Term Paper

… While holistic medicine may not be the best solution for everyone, it definitely seems to have its benefits. Holistic doctors aim to treat their patients or clients psychologically, spiritually, emotionally and socially, as well as meet their physical needs. This enables people to be more active in self-healing.

Bibliography

ICPAC. (2003). Interview with a Chiropractic Physician. Indiana Career and Postsecondary Advancement Center. Retrieved on the Internet at http://icpac.indiana.edu/careers/health/chiro.xml.

Charlton, Bruce G. (November, 1993). Holistic medicine or the humane doctor? British Journal of General Practice, pp. 475-477.

Keller, Edmund. (November, 1998). Homeopathic Solutions. Journal of the American Medical Association, pp. 182-189.

Bentley, Charles. (Sept. 2, l998). The Alternative of Holistic Healing. Journal of the American Medical Association, pp. 45-49.

Dworkin, Norine. (November, 1999). The Holistic Medicine Cabinet. The Vegetarian Times.

Gareth, Kathleen. (2002). Healing with Homeopathy. The Standing Post. Retrieved from the Internet at http://www.standingpost.com/homeopathy.html://www.standingpost.com/homeopathy.html.

Wolff, Amy. (2001). Holistic Medicine Trends. PetPlace. Retrieved from the Internet at http://www.petplace.com.

Aromatherapy: A Complete Guide to the Healing Art, by Kathi Keville and Mindy Green (The Crossing Press, 1995). Explains how to enhance health and well-being with essential oils.

Bach Flower Therapy, by Gotz Blome, M.D. (Healing Arts Press, 1999). Promotes the use of floral essences for treating ailments.

The Consumer's Guide to Homeopathy, Dana Ullman, M.P.H. (Putnam, 1995). Offers well-organized explanations of appropriate remedies for various medical conditions.

The Way of Herbs, by Michael Tierra, LAc., O.M.D. (Pocket Books, 1998). Outlines the therapeutic use of herbs.

Vaidya, Prabha. Gore, Jerry. (2001). Holistic Medicine; Body-Mind-Spirit. Retrieved on the Internet at http://www.yogachicago.com/sep00/holisticmedicine.shtml.

Smith, Robert. "The Magic of Homeopathy" Total Health vol. 15 August 1993 p.10.

Deliman, Tracy. Smolowe, John. (1982). Holostic Medicine: Harmony of Body Mind Spirit. Virginia: Reston Publishing Company.

Ten Most Commonly Asked Questions About Alternative Medicine. http./ / www.healthy.net/library/articles/morton/ten.html1998.

Weston, Walter. (2002). Cancer and Holistic Medicine. Optimal Life Center. Retrieved from the Internet at http://4optimallife.com/index.html.

Holistic Medicine… [read more]


Tylenol to a Friend Admission Essay

… I have worked in summer camps, and volunteered in after school programs. I have volunteered at the YMCA with programs for the elderly and have visited nursing homes. These experiences have not only helped to develop leadership skills within me, but they have shown me the vitality of the human spirit, and have given me the desire to work in a profession that can heal the body.

While none of these activities related directly to pharmacy, I feel that the experience I have gained, paired with the academic programs I have completed, will make me successful in the Pharmacy program, and as a professional pharmacist. I am hard working and have a desire to help people in their time of fear and pain, to ease their fears and help to heal their bodies. These experiences do indeed, I believe, reflect the underlying qualities that are not only desirable in a pharmacy student, but necessary.

I believe that I will be an asset to the program. My qualifications and my desire, coupled with my experience will make me an excellent pharmacist. It is my anticipation that the experience I gain in the program will serve accelerate my goals, and to provide focus and refinement of the skills I already possess. I look forward to being a part of such a respected and highly esteemed group of professionals and I hope that the path to such a goal includes…… [read more]


Business Sustainability Research Paper

… ¶ … Strategic Multilateral Partnerships Help Address the Limitations of Access to Essential Medicines in Emerging Markets?

The Case of Anti-Malarial Drugs in Nigeria.

Business Case Background

The Company Challenge

Opportunities

Business Case Analysis

Wider Sustainability Context

Conceptual framework

Stakeholders… [read more]


Creating Urgency in the Field of Medicine Essay

… ¶ … Chaos, & Complexity

Change, Chaos, and Complexity

One of the most profound changes that I have experienced in my nursing practice is the implementation of remote digitally supported medicine that is commonly referred to as telemedicine. Although the changes that support the eventual universal application of telemedicine have occurred in bits and pieces, so to speak, taken together, these changes have the potential to transform medical practice. Already, there are hospitals equipped to let parents of premature or acutely ill babies observe their infants -- and the care that they receive -from their own homes at all hours of the day and night. This enables the parents and practitioners to engage in close communication about the infant's care and to establish trust to reduce parental anxiety and induce confidence in the provision of care. Telemonitoring also fosters high levels of adherence to medication and health regimens by using mobile phone technology to communicate via text messages. This version of telemedicine ramps up the quality of care that patients living in remote areas can receive, and also reduces the cost of care by reducing the frequency of trips to centralized medical facilities.

Digital mobile devices and the platforms on which they operate have been described as disruptive technology because they disrupted the existing technological systems and practices. In their study of complexity, Snowden and Boone (2007) argue that in a dynamic system, "the whole is greater than the sum of its parts, and solutions can't be imposed, rather, they arise from the circumstances" (p. 3). This phenomenon, called emergence, is what made it possible for physicians to utilize videotelephony to communicate with parents of premature babies while providing care in the newborn intensive care units (NICU). As a leader in nursing, I believe it is crucial to remember this point made by Snowden and Boone (2007): "…best practice is, by definition, past practice…since hindsight no longer leads t foresight after a shift in context, a corresponding change in management style may be called for." (p.4). In complex contexts, best…… [read more]


Drug Business Case Study

… Health Care

The pharmaceutical industry is defined as "all enterprises that were involved in the invention of drugs, the production of the active substances in drugs, the formulation of drugs and the promotion of them to the public, as well… [read more]


Treatment Plan for Cardiomyopathy-Congestive Heart Failure Patient Case Study

… Education Plan as Part of Treatment

The heart failure screening plan has shown to be effective in teaching evidence-based treatment and adequate intervention and patient education to practitioners (Packard et al., 2010). It increases practitioner knowledge and confidence in administering therapy management to CHF patients. Its guidelines have demonstrated successes in administering and managing medication and patient education. These guidelines enable hospitalized CHF patients to understand indications, dosages, effects of drugs, and recognize common side effects. They also help patients understand the importance of taking medications regularly and as prescribed. New guidelines were created in 2009 by the American College of Cardiology Foundation and American Heart Association. These new guidelines are adjusted to individual patient conditions, with emphasis on the six aspects of care, diet, discharge medication and adherence, persistence and dose filtration, follow-ups, daily weight monitoring, and measure to take when symptoms get worse (Packard et al.).

Teaching Plan

In the case of Mr. P, this teaching plan consists of the 6 aspects of diet, discharge medications and adherence to them, activity balanced with rest, regular follow-ups, daily weight monitoring and actions to take if symptoms worsen. The multidisciplinary team to handle his case should include a counselor or psychologist and a social worker. The counselor or psychologist shall manage the resistance and negative attitude of the patient and his wife towards Mr. P.'s condition. And the social worker will assist in locating foundations and other non-government organizations providing financial medical assistance to ailing senior citizens.

BIBLIOGRAPHY

Jaarsma, T. (2005). Interpersonal team approach to patients with heart failure. Vol. 91 #

6, Heart: BMJ Group, Inc. Retrieved on July 13, 2014 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1768956

MedicineNet (2014). Definition of congestive heart failure. MedTerms. Retrieved on July

17, 2014 from http://www.medterms.com/script/main/art.asp?articlekey=6972

NHLBI (2014). Congestive heart failure. National Institute of Health. Retrieved on July

17, 2014 from http://www.medterms.com/script/main/art.asp?articlekey=6972

Packard, K.A. (2010). Teaching heart failure treatment guidelines and assuring heart therapy. Vol. 74 # 6, American Journal of Pharmaceutical Education: American

Association of Colleges of Pharmacy. Retrieved on July 13, 2014 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933012

X-Plain Patient Education (2013). Congestive heart failure. The Patient Education

Institute, Inc. Retrieved on July 13, 2014 from http://www.ncbi.nlm.nih.gov/medlineplus/tutorials/congestiveheartfailure/ct129106.pdf… [read more]


Poly-Pharmacy Low Income Elderly and Social Theories Essay

… However, there needs to be a specific and laser focus on the poor as they are more likely than most to forgo medications or other treatments because they perceive that they have no other options. However, through proper medical care and the use of government programs and best practices, that is absolutely not the case.

Conclusion

The social safety net in the United States will be tested more and more as the next two or three decades roll on. With the solvency issues that Social Security, Medicare and Medicaid are all having, there needs to be a focus on getting the assistance to where it needs to be and to avoid sending it to where it is not needed. Best practices should always be employed to prevent unneeded or unnecessary care. Even when care is clearly needed, it should be done in an efficient and caring way that attends to the needs of the patient and the streamlining of care at the same time. Part and parcel of using evidence-based care is to use social theories, both nursing and non-nursing, to keep the process and the results as proper and efficacious as possible. Doing otherwise is a disservice to the patient and the system.

References

Allen, K.R., Hazelett, S.E., Jarjoura, D., Wright, K., Fosnight, S.M., Kropp, D.J., & ...

Pfister, E.W. (2011). The after-discharge care management of low income frail elderly (AD-LIFE) randomized trial: Theoretical framework and study

Design. Population Health Management, 14(3), 137-142.

doi:10.1089/pop.2010.0016

Eckstein, D., Eckstein, D., & Mullener, B. (2010). Seven psychological considerations in working with elderly adults. Journal of Education & Sociology,

(4), 4-15.

Hearn, S., Saulnier, G., Strayer, J., Glenham, M., Koopman, R., & Marcia, J. (2012).

Between integrity and despair: Toward construct validation of Erikson's Eighth

Stage. Journal of Adult Development, 19(1), 1-20. doi:10.1007/s10804-011-

9126-y

Sergi, G., De Rui, M., Sarti, S., & Manzato, E. (2011). Poly-pharmacy in the elderly: Can

comprehensive geriatric assessment reduce inappropriate medication

Use?. Drugs & Aging, 28(7), 509-518. doi:10.2165/11592010-

Vieira, L. (2013). The elderly and the family caregiver: Home care in the light of Imogene…… [read more]


Status of the Nation's Drug Supplies Term Paper

… The PDMA was passed in response to growing concerns over counterfeit pharmaceuticals in the United States. In this regard, Conlan advises that, "To a large degree, [the PDMA] was spurred by the discovery of two million birth control pills meant… [read more]


Docs Drugs "Doctors Often Accept Essay

… Docs Drugs

"Doctors often accept gifts from drug companies," (Chren, Landefeld & Murray, 1989). Sometimes, this issue is framed as an ethical problem. Doctors who accept money are believed to be unethical. However, the solution to the problem depends on the ethical framework being used. There is no clear reason why there is an ethical problem in this case. Doctors are highly trained professionals who are entrusted with the most intimate details of our lives. Therefore, it is unethical to assume that doctors are doing something wrong when they accept gifts from pharmaceutical companies. Doctors would not know about drugs if the pharmaceutical companies did not market the drugs they manufacture, or rebrand the drugs that are already made to be used in new ways. Therefore, the best way to tackle the ethical problems of the doctor-drug company relationship is to foster that relationship as being one of caring and compassion. The best ethical approach to take in addressing this situation is utilitarianism and libertarianism. According to the Institute for Humane Studies (2013), a libertarian is someone who believes that "people should be permitted to run their own lives as they wish." From this point-of-view, it is ethical to allow both doctors and drug companies to practice as they wish. Patients have a full responsibility to be educated about their personal health, and cannot place the burden of ethical responsibility on other people like doctors. Doctors do what they wish because they are trained professionals, which is why the government allows the pharmaceutical companies to market to them. If there was a problem with this relationship that was seriously harming people, then the government would be forced to intervene. The utilitarian maxim is doing that which causes the greatest good to the greatest number of people. Marketing pharmaceuticals to doctors could save lives, by introducing doctors to medications and interventions that might be used on patients. It is ethical to promote the doctor-pharmaceutical relationship and unethical to impede that relationship.…… [read more]


Translating Evidence Into Practice Research Paper

… Nursing Research

PICO Question -- Are Guided Imagery techniques effective in the management of pain?

The objective of this research study was to investigate the effects guided imagery sessions have on the management of pain. Nursing theory is both carative… [read more]


Transcultural Nursing Essay

… CAM Therapy:

According to the findings of the National Health Interview Survey in 2007, many Americans i.e. 38% of adults tend to use Complementary and Alternative Medicine (CAM) in their efforts to be healthy and promote their well-being ("What is Complementary and Alternative Medicine?" 2012). One of the major types of complementary and alternative medicine is natural products that incorporate the use of various herbal medicines or botanicals, minerals, vitamins, and other natural items. While this CAM therapy also includes probiotics, most of the natural products are sold over the counter as dietary supplements. Probiotics are live microorganisms or bacteria that are akin to microbes usually found in the human digestive tract that have beneficial impacts. The origin of this CAM therapy can be traced back to the first attempts by people to use botanical medicines to enhance the human condition. In 1991, during the prehistoric ice man, one of the personal effects found in the Italian Alps was medicinal herbs.

While the use of natural products has become very popular in America, patients considering using this CAM therapy should discuss the decision with their nurse of physician and seek for information regarding the therapy. This is an important step because the therapy may interfere with standard treatment or be detrimental when incorporated with traditional medicine. However, the use of natural products in treatment of health issues is usually surrounded with concerns regarding the safety and effectiveness of the practices. Therefore, the nursing implications for patient assessment for this CAM therapy involve addressing the myths and concerns associated with the effectiveness and safety of natural products. Health care providers should include the issue of natural products as part of patient assessment because many patients use the therapy without informing their physicians or nurses. Such discussions would help to ensure a personalized effective and secure integrative health care plan.

Religious/Spiritual Organization:

Religion or spirituality is a major concept that has significant impacts on the physical and mental health of…… [read more]


H1N1 Executive Summary and Issue Statement Tennessee Term Paper

… H1N1 Executive Summary and Issue Statement

Tennessee had multiple reported cases within less than one month of the virus reaching the United States. In order to mitigate the spread of the disease, Tennessee formed a network of politicians and experts to coordinate and advise all sectors of the state and ensure timely organization and distribution of medicines and vaccines. In order for the panel's goals to be met, the state had to usurp much of the power that was given to local governments and in doing so ensure united policies and strategies to stop the spread of the virus. While Tennessee's overall results far exceeded the national results in both vaccine distribution and disease prevention, there are still many measures that must be improved before the next outbreak. A successful response to future influenza outbreaks requires increased devolution of power to states, localities, and businesses.

During the 2009 H1N1 outbreak, there were six actors selected to aid in mitigating the spread of the disease: the state of Tennessee, the World Health Organization, the United States Federal Government, local health departments, non-government organizations including private businesses, and organizations in charge of at-risk populations. These organizations came together and formed two successful strategies that mitigated the outbreak in Tennessee: the for-profit drug distribution program and the preparedness coordination with the Tennessee Hospital Association. Additionally, the state's response revealed the dangers of depending upon foreign nations for vaccine purchases. Once this issue was overcome and vaccines were made available, the state had already prepared the proper lines of communication and distribution allowing higher vaccine rates than the rest of the country.

Issue Statement

Taskforce Purpose and Charge

When the 2009 H1N1 outbreak was declared a pandemic by the World Health Organization, the state of Tennessee formed a taskforce to combat and prepare for the oncoming spread of the virus. The Governor's Taskforce on Disaster Preparedness for Pandemics was tasked with thinking ahead to the next event and making recommendations to the Governor on how to prepare for and manage the next pandemic threat to the great state of Tennessee.

The first goal appointed to the taskforce was to work with other members for the Public Affairs community. This goal was accomplished through clear and detailed public speeches where questions were answered freely and information was readily given. At the start…… [read more]


Flooding Lessons Learned Essay

… Flooding Lessons Learned

One of the more serious natural disasters that affected the United States in recent years was that of Hurricane Katrina, a 2005 disaster that had over a $100 billion effect on the U.S. Economy, interruption of the Gulf oil supply, ruin of exports and forestry, thousands unemployed or displaced, and a huge impact on tourism in the Gulf States (Reidy, 2005, Cooper, 2007). Katrina was a call to action for the system of crisis management, whether public or private, and changed the approach to natural disasters; hopefully allowing for firm and structured plans and a robust communication and cooperation paradigm.

Emergency Prescription Assistance Program

EPAP is designed to assist individuals in Federal -- identified disaster areas who are in need of prescription medication. Pharmacies are part of society's infrastructure in public health and healthcare, and after a disaster, many are closed, destroyed, or unavailable. In addition, the distribution system to delivery drugs to individuals is usually compromised. As part of the Robert T. / Stafford Disaster Relief and Emergency Assistance Act, EPAP activities provide essential assistance to support state, regional, and local jurisdictions in getting both Durable Medical Equipment and at least a 30-day supply of medication to treat an acute condition or to replace maintenance programs that were affected by disaster (Emergency Prescription, 2012).

Benefits -- the benefits to the program are many. The program will allow life-saving drugs to be delivered even if local hospitals and pharmacies are shut down, as well as delivering new medications or equipment for those severely affected by the disaster. The program is set up so that there is no cost to individuals for this service, and the service will network into other pharmacies in other areas (for those evacuated) so that they, too, can continue with their needed medications.

Barrier to Effectiveness- as of October, 2012, no Presidential Emergency Declaration or Major Disaster Declaration has been issued and EPAP remains inactive (Emergency). Therefore, the barrier to effectiveness is approval for funding and ensuring that the infrastructure will support the program.

State Social Media Sites

Forty million people use social media on a…… [read more]


Pharmacist.In This Case, Case Study

… ¶ … pharmacist."In this case, the pharmacist is faced with a moral and ethical dilemma of informing one Mr. Ramirez's (a congestive heart failure patient) doctor, the risks that he might be exposing himself to by his tendency/trend of increasing… [read more]


Alternative and Complementary Healing Practices Research Paper

… Alternative and Complementary Healing Practices

Many people around the world are spending huge amounts of money on alternative and complementary medicine treatment options every year. The reason for this is that these alternative treatment options do provide quick recovery options… [read more]


Aspirin Usage in Patients Research Paper

… Aspirin Usage in Patients With Type 2 Diabetes

Aspirin Usage in Patients

Should aspirin be used in primary prevention of cardiovascular mortality and morbidity in patients with Type 2 diabetes?

Should aspirin be used in primary prevention of cardiovascular mortality… [read more]


Drug Monograph Essay

… Drug Monograph

FOR SERIOUS INFECTIONS ONLY

Drug Monograph: Vancomycin

Drug Name -- Vancocin (brand), Vancomycin HCL -- oral (generic)

This is a time-dependent bactericidal antibiotic, which inhibits cell wall synthesis (Levinson, 2009).

Glycopeptides

VA Class - AM900

CAS Number 1404-93-9… [read more]


Grant Proposal on Outcomes Grant Proposal

… Yet, it must also be made clear that Fibrinolytic therapy is a good alternative in situations where PCI is not rapid and/or even effectively available in the acute setting. The work proposed in this grant request will first review existing scholarly medical research associated with the outcomes of exclusive fibrinolytic therapy vs. primary percutaneous coronary intervention (PCI), looking specifically at timely vs. later administration of PCI in STEMI.

The work will then move on to look at historical outcomes data regarding patient intervention of exclusive fibrinolytic therapy vs. primary percutaneous coronary intervention (PCI) in patient cases at a major cardiac center and then comparatively at a rural hospital dealing with STEMI on a regular basis. The work will attempt to review the outcomes of fibrinolytic therapy vs. primary percutaneous coronary intervention (PCI) in situations where the door-to-balloon window is more likely to be bridged beyond the 90 minute window.

The work will look at cases of STEMI that have occurred within the last 3 years to judge outcomes of these two therapies in cases where they are used independently of one another during acute STEMI presentation, i.e. within the first 4 hours of acute intervention. The analysis will then calculate variances in outcomes over the year following the acute STEMI event looking for repeat occurrences of acute cardiac and/or thrombolytic events.

Conclusion

This work will serve as a basis for a greater understanding of outcomes associated with the training, availability and acute application of PCI in STEMI and look at fibrinolytic therapy as a viable treatment response to STEMI in cases where PCI is not available or administered in a timely manner. Even most small and rural hospitals have at least some availability for trainin in acute cardiac crisis, associated with the use of PCI but it is not clear that its application has been adopted as the only and best treatment for STEMI and other acute cardiac events. This work will look at the varied outcomes and also the tendency of less sophisticated treatment sites to use fibrinolytic therapy as a viable alternative with positive outcomes sand at the very least as a stabilizing treatment associated with identified need to transfer STEMI patients to more specialized facilities often over significant distances in time and miles.

Rural hospitals with limited response alternatives often must seek the least invasive and least damaging treatment options for patients who present with conditions they are poorly equipped to deal with. In the case of STEMI this is sometimes assumed to lead to less than favorable outcomes, yet the research needs to be much more thorough and ongoing to determine if these less invasive and less specialized responses allow for outcomes that give the patient time to reach more advanced care. Best practices for alternative responses are to STEMI need to be well established, especially in places where PCI is not an alternative for rapid response treatment, regardless of the desire to provide the best possible and most advanced emergency treatment at all times.

Resources… [read more]


Macpherson, Thorpe, and Thomas ) Article Review

… This type of research concerning acupuncture's effectiveness could be designed around a depiction of the treatment that transcends just the process of needling and incorporates the associated diagnostic, treatment, and the therapeutic relationship components that are specific to acupuncture as… [read more]


Clinical Decision Making Process Essay

… " (Mangoni and Jackson, 2004) The elderly patient experiences changes in their stomach and primarily in regards to changes involving "the secretion of hydrochloric acid and pepsin, which are decreased under basal conditions." (Mangoni and Jackson, 2004) The liver is also affected by aging in regards to a "progressive reduction in liver volume and liver blood flow." (Mangoni and Jackson, 2004) Finally, there are body composition changes that are significant in the elderly in that there is reported to be a "progressive reduction in total body water and lean body mass, resulting in a relative increase in body fat." (Mangoni and Jackson, 2004)

IV. Pharmacodynamics and Pharmokinetics of Common Medications

Pharmacodynamics refers to what medication does when administered and pharmokinetics refers to what the body does with the medication. In the elderly, impact of the advances of aging results in the body's functions becoming impaired in the regulatory processes providing "functional integration between cells and organs." (Mangoni and Jackson, 2004) The result is a "failure to maintain homeostasis under conditions of physiological stress." (Mangoni and Jackson, 2004) This reduction in homeostatic ability is reported to negatively impact various regulatory systems in the elderly individual's body resulting in significant pharmacokinetic and pharmacodynamic changes. Included in pharmokinetic changes is a reduction in "renal and hepatic clearance and an increase in volume of distribution of lipid soluble drugs" and the prolonging of elimination half-life. (Mangoni and Jackson, 2004) Pharmacodynamic changes are reported to be such that "involve altered sensitivity to several classes of drugs such as anticoagulants, cardiovascular and psychotropic drugs. " (Mangoni and Jackson, 2004)

Summary and Conclusion

The nurse plays a significant role in the administration of medication to the elderly and therefore must be aware of the legal and ethical issues related to medication administration to those who are advancing in age. As well the nurse must necessarily be aware of the changes that the body of the elderly person is undergoing in order to safety administer medicine to this specific patient group.

Bibliography

Harris, H. (2012) The Nurse's Role in Geriatric Medication Safety. Retrieved from: http://www.ehow.com/about_6544279_nurse_s-role-geriatric-medication-safety.html

Hauswirth, K (2012) Administration of Medication. Healthline. Retrieved from: http://www.healthline.com/galecontent/administration-of-medication

Mangoni, AA and Jackson, SHD (2004) Age-Related Changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. Br J. Clin Pharmacol. 2004 January…… [read more]


Drugs and Medicine Term Paper

… Chemistry is doing more than simply turning liquids different colors in vials. In fact, one of the most cutting edge areas of modern chemistry is drug innovation. Chemists within drug pharmacology are discovering drugs that do everything from reducing inflammation… [read more]


Medication Administration Tech Policy Research Paper

… The system could also go farther if the institution decided to implement a patient bracelet system such as are found in nearly all hospitals and many other medical institutions in the U.S. This type of barcode system, referred to as a point of care system works basically like this:

The basic concept for a bar code point-of-care test is that information is encoded in bar codes, allowing for the comparison of the medication being administered with what was ordered for the individual patient (Sakowski et al.,2005). After a medication order is written (electronically or manually), a pharmacist enters, verifies, and profiles the order. Prior to administration of the first dose, the nurse confirms a match between the written and electronically profiled order. When the nurse is ready to administer a medication to a patient, he or she uses a handheld bar-code reader to scan the patient's special wristband and medication, at which time the software verifies it is the correct medication and dose as well as the correct time and patient. (Fowler, Sohler & Zarillo, 2009, p. 106)

This system would then allow the nursing staff to be assured that traditional medication errors error are rarely made, especially at the point of delivery and with the integrated inventory and manufacturer bar code system in place and accuracy of pharmacist fill and physician orders many fewer errors are made from order to delivery (Fowler, Sohler & Zarillo, 2009).

Research on bar code reading systems in both the pharmacy and at point of care is relatively new, but is very promising in its results of long-term reduction in medication errors (Fowler, Sohler & Zarillo, 2009). More research clearly needs to be done as more and more of such systems are implemented. This research is integral to a greater understanding of how the systems need to be altered to best meet the goal of excellent patient safety with regard to medication errors as well as ease of use and practicality for staff. The most important research should be focused on how to best develop and tweak bar code systems so they are both most effective in reducing medication errors and highly usable and functional for staff (Wild, Szczepura & Nelson, 2011).

There is a clear sense of the changing times associated with medical care technology and ultimately such technology has patients' safety as a priority. With a new Bar code point of delivery system the challenges of medication administration will decrease over time and allow integrated systems to create higher delivery value and more efficient operations (Fowler, Sohler & Zarillo, 2009). Though all change takes time to be integrated and accepted many changes are patient centered and therefore seek a higher quality of care. Therefore it is recommended that the Utah State Hospital adopt such technologies and integrate them to develop more timely care and safer delivery of medication to patients.

Resources

"ASHP statement on bar-code verification during inventory, preparation, and dispensing of medications: developed through the ASHP Section of Pharmacy Informatics and… [read more]


Joint 7-Year Program Provides a Unique Opportunity Application Essay

… ¶ … joint 7-year program provides a unique opportunity for the right student: a student that maintains high academic standards and is dedicated to the medical profession. For the right motivated individual, this program gives them an accelerated route to… [read more]


Robert Courtney Case Term Paper

… Robert Courtney Case

Robert Courtney was a successful pharmacist in Kansas City, MO, who got greedy and decided he would water down cancer-related drugs in order to pocket money for himself. He did not get away with his ill-gotten gains, and in fact he has admitted his guilt and has been sentenced to up to thirty years for his crimes. This paper delves into the life and crimes of Courtney, who was a minister's son and was active in the Northland Cathedral Pentecostal Church, giving large amounts of money to the church building fund, and singing in the choir.

What did Courtney do to land in federal prison? CBS News reports that Courtney admitted to watering down the drugs of thirty-four cancer victims; but authorities familiar with the Courtney case say he may have "diluted 98,000 prescriptions" that were issued through "about 400 doctors" possibly having a negative affect on up to 4,200 patients" (Freed, 2009, p. 2).

The drugs that Courtney admitted diluting were Taxol and Gemzar (drugs used for chemotherapy patients) and cancer-fighting drugs, Platinol and Paraplatin, according to Freed's account in the CBS News story. The New York Times reports that prior to Courtney's arrest in 2001, he had "amassed $18.7 million in total assets" albeit he was reporting to the IRS that he earned far less than that (Draper, 2003). The Times' article went into great depths in its investigation, pointing to Courtney's lavish lifestyle, his crude treatment of his second wife (he wanted her to be "…like a doll on a shelf"), and his habit of "fending off inquiries from pharmaceutical reps in the Kansas City region about how much of which drugs he was selling" (Draper, p. 3).

He got caught because "He was sloppy," according to Todd Graves, the U.S. Attorney who served as prosecutor in the litigation against Courtney (Draper, p. 3). The moral code that Courtney operated by "required a rationale," Draper writes. That rationale? "He most likely took comfort in what amounted to his defense in the civil proceedings against him" that regardless of the worthlessness…… [read more]


Effects of Quality Management on Domestic and Global Competition Research Paper

… ¶ … Quality Management on Domestic and Global Competition

Describe OR diagram a process or procedure that is similar between the organizations

The most important process in developing medicines is conducting research and clinical trials. This is mandatory to avoid legal problems and also is the method of ensuring that the derived drug or medicine is effective and without any side effects. The company Pfizer is into R&D for finding new medicines for challenging diseases. The clinical trials of discovered medicines are a process that is very crucial for the medicine to be approved. The regulations are such that there are regulations regarding the clinical trials and rights of the participants. While Pfizer is a research-based company that develops drugs after trial, the Par Pharmaceutical is more of a generic drug company. (Par Pharmaceuticals, 2011)

The difference is that in the case of a generic drug the clinical trials would have already been conducted by the original discovering company. The generic drugs are patent free drug formulas that become so after a lapse of the original patent. Pfizer is also a generic drug manufacturer and both are thus able to give out low cost drugs in the market. Par Pharmaceutical confines itself to the market in the United States and is recently gone global. In the case of Pfizer, it is a multinational drug company. Each company has its own policies and positions regarding the clinical trial. The process in the clinical trial is long and elaborate. (Clinical Trials. Gov, 2007)

The selective use of the medicine discovered of patient volunteers who meet the conditions are of two types-interventional and observational. In the interventional type the volunteers are subject to the treatment and the results and the reactions measured and the result shows the success of the formulation. In the second type that is the observational the volunteers are just observed without the induction of the drug and comparisons created. The protocols for the trial is common for all companies and participants and all such trials in the U.S. come under the purview of the Institutional Review Board -- IRB and thus institutions that conduct or support biomedical research involving people must have the IRB that approves the research. (Clinical Trials. Gov, 2007)

Clinical trials have different phases. In the first the experimental drug or treatment is confined to a very small group and is tested for safety, dosage range, and side effects. On establishing this, the research moves to the second step a larger group of over one hundred people to see its effect in a larger group. In the third phase the number increase to more than three thousand which can effectively provide a conclusion on the trial. In the last phase the drug is perfected and sent for market study. (Clinical Trials. Gov, 2007) This is the process by which pharmacy companies introduce new drugs.…… [read more]


Allocation of Costs Data Analysis Chapter

… Allocation of costs using ABC and Transitional costing accounting

Allocation of Costs at Jumper Hospital Takes a New Approach

As part of the Jumper Hospital Administrative Coordinator, our committee came together last week for our annually meeting for the fiscal year 2010 to determine that even though we understand the history of a traditional cost, and it has always been our way of handling and determining the allocation of costs to our departmental cost approach we are considering a transformation in to the Activity-Based Costing perspective (WiseGeek, 2011). We, The Committee, feel, after looking at the transitional and ABC approach by conducting two simple diagrams that compares the effectiveness of the accounting system we want to offer to you in this obvious and through explanation in these comparisons.

We used three main parts as part of the ABC method and could only put two of them in place within the transitional model with the example of Resources at the top of both which is used to describe as everything inside the organization which is Jumper Hospital as a whole (all the different departments in relation to the maintenance department. While the resources are everything within the organization the different approaches classify what is considered there and in the activity approach, this is the hospital as a whole and routine repairs needed in each department and in the pharmacy, and then we look at what is used in the repairs in maintenance, how it effects consumers, patients, and staff which lead up the resource development that the research box represents. In the other cost accounting, the resources traditionally include considering be considered in reducing cost and increasing overall revenue and if the services provided should be eliminated. The next box we label in the diagram below the resources box is the activity box in the new approach we are considering and the fact there is no activities listed in…… [read more]


Comparison of Spect Lung Scintigraphy and Ctpa for the Diagnosis of Pulmonary Embolism Article Review

… SPECT vs. CPTA

Pulmonary embolism or PE is the sudden blockage in a lung artery by a blood clot coming from a vein in the leg (NHLBI 2009). PE can permanently damage part of the lung due to lack of… [read more]


Generic Prescription Drug Program as a Pharmaceutical Case Study

… ¶ … Generic Prescription Drug Program

As a pharmaceutical benefit manager, I have a variety of pricing strategies at my disposal, to determine the amount charged to employers for prescription drugs. This paper will briefly assess each of these strategies.… [read more]


Professional Goal Statement Admission Essay

… Application Goal Statement

Personal/Professional Goals

I am applying for a Masters in Clinical Research Administration because that field will allow me to apply my degree in medicine directly to scientific research. While I hope to start a medical residency in two years, I am not in a rush to do that at the expense of achieving the most well-rounded and comprehensive education and training possible. In the long-term, I would like to preserve as many options as possible for the direction of my future practice. In addition to helping me become the best physician that I can be, I believe that the Masters in Clinical Research Administration will allow me to contribute to human healthcare in a broader capacity than a scientific degree by itself.

Academic Experience

I was awarded a Bachelor of Science degree in Biology from UTSA in 2000. Thereafter, I interrupted my pursuit of a Masters degree in Biotechnology Research after completing 32 of 36 hours required for that degree because I was accepted to the Universidad Autonoma de Guadalajara School of Medicine in my last semester. While I regret having had to make that choice, my academic experience at ____ firmly established in me the interest in clinical research that I hope to explore more fully in connection with administrative responsibilities at

Research Experience

My research experience is limited to three semesters as a research assistant at the UTHSC in San Antonio. In that capacity, I also worked under Dr. M Gdovin in the Biology Department as a teaching assistant at UTSA. I fulfilled a UTSA Neuroscience internship funded by the NIH and another NIH internship in Abuja, Nigeria.

Work / Other Experience

At the Universidad Autonoma de Guadalajara School of Medicine, I fulfilled an 8-week clinical rotation in each of the following disciplines: Internal Medicine; Pediatrics; Obstetrics, Labor and Delivery & Gynecology; Trauma and Orthopedics; Elective Rotation in…… [read more]


Medical Safety Poor Essay

… Over the past decade, efforts have been made to define and measure medical related errors. A huge problem has been indentified to the tune of $2 billion dollars a year which represents the cost of preventable medication related errors. Since identifying these serious problems, several valid solutions have been proposed and implemented in many medical establishments. Standardization and use of new technology to improve accuracy have proven to be excellent weapons in the fight against medication related errors.

Standard Protocols and Procedures

Standard protocols and procedures is an effective way to begin to eliminate common mistakes. Standardizing the way in which work is performed and managed within a medical establishment is the low-hanging fruit in the quest to improve medication-related errors. Standardizing protocols, devices and procedures amongst medical facilities across the nation will allow our healthcare provider system to run as a well-oiled machine. Reducing variation in processes, policies, procedures and devices across the board will allow for increased precision and delivery of services without defects. Standardization allows for controllable treatment procedures with predictable and repeatable outcomes.

Technology to Improve Accuracy

Dosing errors can be eliminated through the use of technology. Dosing errors include administration, prescribing and dispensing errors. Prescriptions written in one unit such as micrograms and calculated in another unit (such as milligrams) is a very preventable error. Tools such as the CPOE or Computerized Physician Order-Entry System which allows orders to be written directly into the computer and transcribed to the pharmacy and the Automated Dispensing Cabinets (ADC) which has an automated dispensing system with frequently used medications in patient-care areas have proven to be great in reducing dosing errors. Nearly 60% of hospitals in the United States use the ADC process (Grissinger & Globus, 2004). CPOE has also shown positive results and is responsible decreasing medication errors by 40% in facilities it has been used.

Unfortunately, a recent study suggests no progress in patient safety in the past decade a meager 1.5% of hospitals are utilizing methods and systems that have already shown success. What this means is 98.5% hospitals around the country have the opportunity to save lives, reduce overall costs and provide better care and they are opting out. The study conducted by The New England Journal of Medicine suggests that the rate of adverse affects due to medical errors hasn't budged since the 1999 study. What do we do? Now is the time to hold medical facilities accountable. Patient safety isn't option, it is mandatory and all medical facilities from administration to staff should be committed to the elimination of these errors. Government (both federal and state) should institute a score card which rates hospitals on their implementation and results in the reduction of medical errors. If the only way to get medication safety to be a priority to medical facilities is to force them to comply, then the government should take action. How many more people must die and be harmed unnecessarily? Our future focus should be on instituting mandatory requirements on… [read more]


Efficacy and Safety of Dabigatran Research Paper

… In terms of safety, the results are mixed. For example, increased reports of dyspepsia (Schulman et al., 2009) and major gastrointestinal bleeding (Wallentin et al., 2010) in patients taking 150 mg dabigatran twice daily suggest warfarin might be a better anticoagulant choice for patients with a history of bleeding ulcers and other forms of gastrointestinal distress. Although Ezekowitz et al. (2007) reported increased rates of "gastrointestinal symptoms" in patients receiving dabigatran at 50, 150, and 300 mg dosages, when compared to warfarin, patients taking dabigatran with or without aspirin were grouped together. The overall safety of dabigatran vs. warfarin was established in the large phase III clinical trial (Connolly et al., 2009), but this was called into question by the results of Schulman et al. (2009) and Wallentin et al. (2010) after they analyzed all adverse events or all adverse coronary outcomes, respectively. The results from these comparisons suggest warfarin is safer overall. Wallentin et al. (2010) showed that any safety advantage that dabigatran treatment might provide was erased for many adverse outcomes at centers predicted to provide higher quality of care. This could be an important consideration for clinics with suboptimal resources and funding. Any advantage that dabigatran is predicted to provide because it requires less intensive monitoring seemed to be erased by higher rates of patient non-compliance due to adverse events (Ezekowitz et al., 2007; Schulman et al., 2009), but as the authors mentioned in the phase III clinical trial the major gastrointestinal bleeding and dyspepsia problems associated with dabigatran may have to do with inclusion of tartaric acid in the dabigatran formulation to aid absorption. The general, overall conclusion is that dabigatran is at least as effective as warfarin in protecting patients against stroke and systemic embolism, but the few remaining safety concerns are serious enough to warrant further study.

Notes

Centers for Disease Control and Prevention. "Public health and aging: Atrial fibrillation as a contributing cause of death and Medicare hospitalization -- United States, 1999." Morbidity and Mortality Weekly Report 52 (2003): 128-131. Web.

Connolly, S.J., Ezekowitz, M.D., Yusuf, S., F.R.C.P.C., D.Phil., Eikelboom, J., Oldgren, J., Parekh, A., Pogue, J., Reilly, P.A., Themeles, E., Varrone, J., Wang, S., Alings, S., Xavier, D., Zhu, J., Diaz, R., Lewis, B.S., Darius, H., Diener, H-C., Joyner, C.D., Wallentin, L., and RE-LY Steering Committee and Investigators. "Dabigatran vs. warfarin in patients with atrial fibrillation." New England Journal of Medicine 361 (2009): 1139-1151. Web.

Ezekowitz, Michael D., Reilly, Paul A., Nehmiz, Gerhard, Simmers, Timothy A., Nagarakanti, Rangadham, Parcham-Azad, Kambiz, Pedersen, K. Erik, Lionetti, Dominick A., Stangier, Joachim, and Wallentin, Lars. "Dabigatran with or without concomitant aspirin compared with warfarin alone in patients with nonvalvular atrial fibrillation (PETRO Study)." American Journal of Cardiology 100 (2007): 1419-1426. Web.

Lemos, Silva R., Carvalho de Sousa, J., Calisto, C., Nogueira,…… [read more]


Pre-Medications Current Practices Capstone Project

… A further study showed that it is not only medicine that can be used as a pre-treatment, but that music could be used as well. What the study determined was that "relaxing music decreases the level of anxiety in a pre-operative setting to a greater extent than orally administrated midazolam" (Bringman, Giesecke, Thorne, Bringman, 2009, p. 759). Other studies have also determined the effectiveness of pre-medication, and perhaps that is one of the reasons why the practice of administering Benadryl or Tylenol before bone marrow transplants continues to take place. Evidence of the ill effects of such actions make this study one of importance to the BMTU across the United States.

Methodology

Many of the consults that take place after investigations to a reaction to blood transfusions recommend that the practice of administering the medicines be discontinued because of the effects of doing so. What this study will seek to determine is whether the administration of Benadryl or Tylenol as a pre-medication is more harmful than beneficial in two specific aspects. Those aspects are the masking effects of the pre-medications and the mild reactions that can be produced by the pre-medications. The methodology used to determine the results will be quantitative in nature due to the fact that the study does not concern thoughts or feelings just physical reactions to the action of pre-medicating.

Numerical data will be gathered in an ongoing basis from patients undergoing bone marrow transplants. The data will be analyzed in quantitative manner with two separate groups; a control group receiving pre-medications of Benadryl and Tylenol and a non-control group who do not receive the pre-medications.

Conclusion

The administering of pre-medications in the BMTU may be a practice that can be terminated. It is hoped that the study will show that such a termination would lower or alleviate the incidence(s) of reaction to blood transfusions before BMTU surgeries. A quantitative analysis is proposed to determine whether the termination of pre-medicating is viable.

References

Bringman, H.; Giesecke, K.; Thorne, A.; Bringman, S.; (2009) Relaxing music as pre-medication before surgery: a randomized controlled trial, Acta Anaesthesiologica Scandinavica, Vol. 53, Issue 6, pp. 759 -- 764

Horng, H.C.; Wong, C.S.; Hsiao, K.N.; Huh, B.K.; Kuo, C.P.; Cherng, C.H.; Wu, C.T.; (2007) Pre-medication with intravenous clonidine suppresses fentanyl-induced cough, Acta Anaesthesiologica Scandinavica, Vol. 51, Issue 7, pp. 862 -- 865

Kennedy, L.D.; Case, L.D.; Hurd, D.D.; Cruz, J.M.; Pomper, G.J.; (2008) Transfusion: A prospective, randomized, double-blind controlled trial of acetaminophen and diphenhydramine pretransfusion medication vs. placebo for the prevention of transfusion reactions, Tranfusion, Vol.…… [read more]


Cam Regulatory Overview Natural Products: Herbs (Botanicals) Term Paper

… CAM Regulatory Overview

Natural products: Herbs (botanicals)

Herbal supplements are regulated by the U.S. Food and Drug Administration (FDA), the same organization that regulates prescription and over-the-counter drugs. Herbs are subject to less stringent regulatory standards. Once it is on the market the FDA can 'pull' a product that has been demonstrated to be unsafe, as in the case of the weight loss herb ephedra. Although supplements are marketed with warning labels that the products are "not intended to diagnose, treat, cure, or prevent any disease" it would seem to be in the public's interest to test new products to ensure that they are not actively harmful (Using dietary supplements wisely, 2009, NCCAM).

Mind-body: Acupuncture

Acupuncture is one of the best-regulated forms of CAM in the U.S. "The practitioner must hold a state acknowledged license. Different states have different rules" (Scientific acupuncture, 2011, Official Website). However, doctors and chiropractors do not have to obtain a license or additional training in the practice -- only non-physicians. Acupuncturists consider this unfair; doctors and chiropractors would counter that additional training would be burdensome, limiting the ability of individuals to find treatment. Few objections have been raised to the current system, except for opponents of the practice who dispute its validity.

Manipulative and body based: Spinal manipulation

Spinal manipulation is not a specific, regulated technique; it is "performed by chiropractors and other health care professionals such as physical therapists" (Spinal manipulation, 2011, NIH). Practitioners are policed by different regulatory bodies within their own fields. Use and competency at the spinal manipulation may vary, depending on the individual's training. As the technique is not a specific method, with a clear history…… [read more]


Compendium to Research in Cardiology Annotated Bibliography

… Sample to the study enrolled 134 out-patients from 18 centers who had existing CRT-D systems with software capable of automatically executing LV threshold measurements. Measurements were downloaded into the random access memory (RAM) of the device. Reported outcomes to the study indicate that the algorithm measured the threshold successfully in 96% and 97% of patients after 1 and 3 months respectivel, with augmentation of the data derived from the Holter monitor analysis where a subset of the test subjects revealed accurate performance of the algorithm. The test supports the claim that the new CRT-D improved ability to maintain LV capture without sacrificing device longevity.

Vasamreddy, C et al. (2006). Symptomatic and Asymptomatic Atrial Fibrillation in Patients Undergoing Radiofrequency Catheter Ablation. Journal of Cardiovascular Electrophysiology, 17(2), 134-139. doi:10.1111/j.1540-8167.2006.00359.x.

Objectives to the investigation to "(i) evaluate the feasibility and results of monitoring patients prior to and following catheter ablation of AF with the mobile cardiac outpatient telemetry (MCOT) system and to (ii) correlate symptoms and the presence or absence of atrial fibrillation (AF)" were designed to demonstrate the potential utility of wireless monitoring systems in the follow-up of AF patients. Of a total of 12/19 consecutive patients with (63%) age 60 ( ± 6 years) with highly symptomatic drug refractory AF underwent catheter ablation, each was provided with a MCOT monitor (CardioNet, USA) for a total of 494 days (11,856 hours) of monitoring. Termination of the study concluded at the end of the study with 6/10 patients completing the test. In those subjects (70%) patients were free of symptomatic AF recurrences compared to (50%) asymptomatic AF recurrences. Some identified poor patient compliance with an intensive monitoring protocol as an important limitation.

Chow, E. et al. (2009). Toward an Implantable Wireless Cardiac Monitoring Platform Integrated with an FDA-Approved Cardiovascular Stent. Journal of Interventional Cardiology, 22(5), 479-487. doi:10.1111/j.1540-8183.2009.00483.x.

The researchers investigate the value of a miniaturized stent-based antenna system for use in wireless telemetry and power transfer for the implanted electronics. Reduced to an area of less than 1 mm2, with a thickness under 300 ?m, research studies implantation of a minimally invasive implantation procedure; allowing the delivery of the stent-based implant in nearly any major vessel of the body. Initial prototype with two stents "configured as a single dipole, a 2.4-GHz transmitter microchip and battery [that] validates transcutaneous transmission through ex-vivo and in vivo porcine" is described.

The stent-based antenna can be used in monitoring of blood pressure from a minimally invasive device inserted for tracking the pulmonary artery in diagnostic and early warning system for cardiac health. In cardiac diagnostics, the foremost challenge in using a like device is the wireless transfer of data and power from within the blood vessel to external devices; whilst maintaining unrestricted blood flow through the artery.

Paoletti, R., Suess, T., Lesko, M., Feroli, A., Kennel, J., Mahler, J., et al. (2007). Using bar-code technology and medication observation methodology for safer medication administration. American Journal of Health-System Pharmacy, 64(5), 536-543. doi:10.2146/ajhp060140.

A three (3) inpatient nursing unit… [read more]

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