"Medicine / Pharmacy" Essays 351-414

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Ritalin: The Case History Term Paper

… However, because of the presence of two stereogenic centers in methylphenidate, this process proved to be challenging. A variety of experiments led eventually to an overall yield of 40% threo-methylphenidate hydrochloride with an excellent degree of enantiomeric purity. (Prashad, 2001)… [read more]

Efficiency of Antibiotic Resistance Gene Term Paper

… What is Known about Tetracycline?

Tetracyclines and its derivatives are antibiotics which inhibit the bacterial growth by stopping protein synthesis in the bacteria. Bacteria must synthesis proteins into energy in order to survive, mush in the same way we synthesize… [read more]

Juanita Rich Essay

… Ethics in Operations

There are a couple of main issues found in the case study pertaining to Juanita R. And the Storefront Clinic that she was operating. Chief among these is the fact that Juanita's clinic had effectively run out of funds. Without adequate funding, the clinic would have to close. Another main issue in this case study is the health of the indigent and underserved population that Juanita is serving. Members of that population are going to the clinic in attempts to attain better health. If the clinic closes, it will be difficult for this population to obtain additional medical treatment. The other main issue is the involvement of the large and well-financed pharmaceutical company that is attempting to fund the clinic in return for gaining "long-term data about a newly developed antihypertensive medication" (p. 51). In doing so, it would attempt to present the aforementioned population with anti-hypertensive medication that is still in the testing phase.

The ethical principles that are being violated would be the dissemination of medication that is still in the testing phase to a poor population so that those serving that population can obtain much needed funds. Were Juanita to agree to the terms of the pharmaceutical company, she would effectively be selling the health of her underserved population for the money to keep the clinic open. Such practices represent a major ethical issue and a violation of conventional ethics that consider the health of a population and its safety much more important than finances or profit. Granted, since Juanita and most of the other clinicians are merely volunteering their time there is no profit involved. Still, she could potentially forsake the health of her patients for funding, which is still an egregious ethical violation.

The ethical dilemma that Juanita is facing is whether or not it is better to have the clinic close and serve none of destitute population that she is attempting to provide services for, or risk its safety by taking funding from the…… [read more]

Drug Treatment for Acute Asthma Chapter Writing

… Dexamethasone vs. Prednisone

Keeney, G.E., Gray, M.P., Morrison, A.K., Levas, M.N., Kessler, E.A., Hill, G.D., Gorelick, M.H., & Jackson, J.L. (2014). Dexamethasone for acute asthma exacerbations in children: A meta-analysis. Pediatrics, 133(3): 493-499.

Prednisone is commonly used by nurses, nurse practitioners, and doctors to treat pediatric asthma events. These medical issues often send the asthmatic person to the emergency department, where they are stabilized and given an oral course of prednisone for five days. However, some small studies have been done that indicate prednisone may not be the only -- or even the best -- answer for acute asthma events in pediatric patients. Another medication, dexamethasone, has been said to work just as well. Large scale studies on that statement have not been conducted, however, until now. The meta-analysis shows that a number of studies have been performed where dexamethasone has been compared to prednisone and has worked for pediatric asthma patients. The overall information from synthesizing these studies indicates that there is no difference in the effectiveness of prednisone and dexamethasone, when given to minors with asthma.

One notable issue is that dexamethasone appears to reduce the instances of vomiting that are seen with the use of prednisone. By keeping that in mind, it may be more beneficial to provide these pediatric patients with dexamethasone, instead of giving them prednisone, since the effectiveness of either choice appears not to be statistically different. Another apparent advantage that dexamethasone has over prednisone is that a shorter course of the medication is needed in order to obtain the same result. Prednisone is typically a five-day course, and is given orally. Dexamethasone, by comparison, is given either orally or as an intramuscular injection, and is a two-day course. This means the pediatric asthma patient receives less of the medication, based on the length of time that medication must be administered. That can help the patient and his or her family…… [read more]

Tuskegee Syphilis Project Term Paper

… The physicians and the staff at the Tuskegee Institute were convinced that the study was a good choice, and that treating the men for their condition could actually harm them, because they had already been sick for so long. Additionally, there was concern that there would not be enough data if the men received treatment, and the study would not be successful. Nurse Rivers was conflicted, but was taught to follow the orders of the doctors. She earned the trust of the men in the study, and when she was told not to treat them, she did not question that. She simply did what she was told. Whether that was ethical can be questioned, but it is important to note that none of the people who worked on the study had any training in medical ethics. All of the people making the decisions were Caucasian, as well, and all believed in what they were doing in that they saw alleged value in the study.

Today, it would not be possible for a similar type of study to be conducted. There are ethical issues that have to be considered and addressed when studies are created and developed, and they generally cannot get approval and funding if they are not adhering to proper medical ethics. Additionally, people in the scientific and medical communities are taught medical ethics during their education, and they know and understand that experimenting on people by deliberately giving them a disease or leaving a disease untreated to see how it affects them is wrong. It is very cruel to use people as human test subjects, and to withhold treatment from them -- especially when it comes to a disease that can cause serious damage to a number of organs and can lead to an early death. The study in Tuskegee was immediately stopped when the story broke in the media, and the same would be true today if a study managed to get that far, but it would be extremely unlikely that it would ever begin at all. Medical ethics would not allow it.… [read more]

Severe Back Pain and Muscle Disorders Term Paper

… How does the treatment vary between musculoskeletal disorder and intervertebral disc disorder?

Doctors will recommend various types of "manual therapy, or mobilization," as therapy for musculoskeletal disorder; some medications may be prescribed: non-steroidal anti-inflammatory drugs; acetaminophen or opioids; any of these medications are typically prescribed for pain. What doctors will try to do is to increase the body's levels of serotonin and norepinephrine (using medications like Ambien, Lunesta, and Rozerem, in "low doses") (WebMD). Moreover, there could actually be injections (of anti-inflammatory medications) around the most painful muscles; and they may be exercise to strengthen the muscles, including stretching; also acupuncture or acupressure can be used along with "relaxation and biofeedback techniques" (WebMD).

Treatment for lumbar disc problems (intervertebral disc disorder) includes some of the same treatments as are recommended for musculoskeletal disorder. For example Medscape suggests that "pharmacotherapy" is appropriate (again, non-steroidal anti-inflammatory drugs although some of the drugs recommended include over-the-counter medication like ibuprofen and acetaminophen). Also opioids help relieve pain, as well as Ketoprofen, Flubiprofen, and Naproxen (Medscape). If by using conservative treatments for six weeks or so the level of pain is not lowered, doctors may recommend "spinal fusion" or "discectomy" or even "injection of chymopapain" (Medscape).

Like the suggested treatments for musculoskeletal disorder, treatment for intervertebral disc disorder may include stretching (which relieves "nerve root compression"), and acupuncture as well as chiropractic adjustments (Mayo Clinic). The intervertebral disc pain can be reduced by using cold packs or hot packs (a heating pad) (Mayo Clinic).

Works Cited

Mayo Clinic. (2012). Intervertebral Disc Disorder. Retrieved July 28, 2014, from http://www.mayoclinic.org.

Medscape. (2014). Lumbar (Intervertebral) Disk Disorders. Retrieved July 28, 2014, from http://emedicine.medscape.com.

National Institutes of Health. (2010). Intervertebral disc disease. Retrieved July 28, 2014,

From http://rarediseases.info.nih.gov.

WebMD. (213). Understanding Spinal Disk Problems -- the Basics. Retrieved July 28,…… [read more]

Research Study Design Research Proposal

… Problem

Will adding frozen pizzas to Karen's Frozen Foods current line of product offerings warrant the expense of doing so?

Research method and sources of information

A focus group of the target audience of teenagers and busy working couples will be used to see if the pizza being test-marketed is appealing. Individuals will be interviewed about their food preferences and given sample pizzas to taste-test. Then, they will answer a quantitative survey on their buying habits.

Nature of data to be gathered and analyzed

A mixed method approach will be used: testers will be interviewed and observed in a qualitative fashion. They will also answer a quantitatively analyzed questionnaire about their tastes, eating habits, and frozen food consumption.

Hypothesis or hypotheses to be proved or disproved

The new frozen pizzas will be popular amongst teenagers and working couples who need to put a hot meal quickly on the table every night.… [read more]

Migraine Pt Migraine Headaches Typically Research Paper

… These medications aim to stop the progression of the headache that has already begun as opposed to identifying triggers or using medications to prevent the onset of headaches (Sheikh & Matthew, 2012). Abortive medications include analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs),… [read more]

Pharmacutical Industry Term Paper

… At present, the age demographic between 40-59 years has the highest rate of diabetes. "However, this age bracket is expected to shift to the age-group 60-79 years by 2030" (Global diabetes drugs market and diabetes services market, 2013, PR Web). The drug maker that can deliver the 'next new thing' in diabetes drug treatment is likely to profit greatly from this surge in diabetes, particularly if it can be tolerated by older patients.

Given that obesity is associated with increased risk of blood pressure, heart disease, and osteoarthritis, drugs which specifically treat all of these obesity-related conditions will grow more in demand. Finally, drugs which treat obesity itself are likely to become of greater interest. Drugs to treat obesity have been stubbornly difficult to develop, given the multifactorial nature of the condition in terms of its etiology and causation. Still, obese patients remain a coveted demographic. "Valued at more than $130 million in 2009, the U.S. obesity drugs market is expected to grow at a healthy compound annual rate of 4.0%, with sales reaching nearly $160 million in 2014" (U.S. market for obesity drugs, 2013, Life Science Intelligence.).

Although the obesity-related drug market provides possible opportunities for marketing to an expanding demographic of consumers, there are concerns that advertising within the industry in general may be constrained by growing resistance to direct-to-consumer marketing, which is being subjected to additional scrutiny by the FCC and FDA. "The average American TV viewer watches as many as nine drug ads a day, totaling 16 hours per year, which far exceeds the amount of time the average individual spends with a primary care physician" (Ventola 2011). Physicians have complained that patients come to their offices brandishing drug advertisements, demanding that they be prescribed a 'hot' new pharmaceutical. There is concern that patients are self-diagnosing for conditions created by the pharmaceutical industry, spanning from illnesses ranging from toe fungus to extreme PMS that requires an antidepressant. Thus, the types of marketing available to pharmaceutical companies will be highly dependent on the whims of government agencies to regulate them. However, the trends regarding obesity seem unlikely to be alleviated, despite public health campaigns to educate consumers in the value of healthy eating.


Berger, R. (2013). Global pharmaceutical industry is in a strategic crisis -- business models must be adjusted. Roland Berger. Retrieved: http://www.rolandberger.com/press_releases/513-press_archive2013_sc_content/Pharmaceutical_industry_in_a_strategic_crisis.html

Carroll, J. (2013). Novo Nordisk betting $3.7B on a blockbuster oral diabetes drug market

Fierce Biotech. Retrieved from:


Diabetes. (2013). WHO. Retrieved:


Global diabetes drugs market and diabetes services market. (2013). PR Web. Retrieved:


Thomas, K. (2012). Generic drug makers facing squeeze on revenue. The New York Times.

Retrieved: http://www.nytimes.com/2012/12/04/business/generic-drug-makers-facing-squeeze-on-revenue.html?_r=0

U.S. market for obesity drugs. (2013). Life Science Intelligence. Retrieved:


Ventola, C.L. (2011). Direct-to-consumer pharmaceutical advertising. NCBI, 36(10): 669-674,

681-684. Retrieved: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278148/… [read more]

Randomized Study Acupuncture Essay

… 5. Outcome measures included a measure of facial nerve function (based on a neurological exam) and disability and quality of life skills (the Facial Disability Index and the Quality of Life score).

6. Results and conclusions. After the follow-up period it was determined that the participants in the treatment group had better facial function, less disability, and improved quality of life based on the outcome measures compared to the control group. Xu et al. (2013) concluded that the stimulant effect of de qi had a greater therapeutic effect and was associated with better outcomes among patients with Bell palsy.

7. Ethical considerations. As with any such study the safety, confidentiality of the participants and the safety of the participants is a strong consideration. In this study the participants all gave informed consent prior to participation, the treatment was performed under the strictest of conditions and acupuncture was only performed by physicians with 10 years or more experience, and patients were followed by a medical team. Confidentiality was maintained. An additional ethical considerations not covered in the article is that the control group should have been offered the treatment manipulation if they so wished following the study. There were dropouts in both conditions and the study does not explain how these participants were followed up.

The study benefited from randomization in being able to establish a causal link between the manipulation and the outcome. Without randomization such a link cannot be determined as there is no control for other possible variables in the sample that can affect the outcome.


Xu, S.B., Huang, B., Zhang, C.Y., Du, P., Yuan, Q., Bi, G.J., ... & Wang, W. (2013). Effectiveness of strengthened stimulation during acupuncture for the treatment of Bell palsy: a randomized controlled trial. Canadian Medical Association Journal, 185(6), 473-478.

Links: Article:…… [read more]

Body Surface Area-Based Dosing Flat Research Paper

… 09 m2

=1.09 m2 / 1.73 m2 = 0.63 X 25 mg = 15.75 mg

It is critical to round off the value to the nearest whole number with the aim of generating an accurate value for the medication. Since… [read more]

Staphylococcus Aureus Is a Type of Bacteria Essay

… Staphylococcus aureus is a type of bacteria that normally resides in or on humans. It is most often diagnosed by obtaining a culture from the areas suspected of infection. The proper method to identify S. aureus is through clinical isolation (Sewell, 2002, p. 1077), using such methods as microscope, colony morphology, and other tests (Rowlinson et al., 2006, 857). One method of growing S. aureus in laboratory, as demonstrated in an experiment, is by using Difco Antibiotic medium III at 37° C. with shaking (Koch et al., 1984, p. 358). What is most important for the growth of the bacteria is the level of temperature which has been demonstrated to interfere with the process (Joyce et al., 1970, p. 323). But what raises concerns nowadays is resistance to antimicrobial agents which can lead to various infections. In this respect, antibiotic resistance can be depicted by PCR and DNA sequencing. Based on their conducted study, Duran et al. (2012), concluded that "the detection of mecA gene by PCR techniques is considered the gold standard method." (p. 394) Because we live in a world surrounded of bacteria, the majority of them undetectable at once, antibiotic resistance poses a great challenge as man is more and more subjected to catching bacteria that are difficult to treat. When the bacteria resides on an individual but is unthreatening, it is said that person is colonized. Colonization can be of various durations, sometimes transient or may establish itself for a period of years in which case it is named persistent (Sanford et al., apud Chambers, 2001, p. 178). Children are more susceptible to catching the bacteria through respiratory tracts, but generally, over 25% to 33% of individuals carry it. The bacteria can also come from poor…… [read more]

Vaccines and the Great Denial Creative Writing

… ¶ … Vaccines and the Great Denial," provides a variety of scientific research that effectively dispels the claim that there is any link between early childhood vaccinations and incurring autism. Despite all of this evidence, the author cites a number… [read more]

Pharma Joan Busfield (N.D.) Explores the Pharmaceutical Essay

… Pharma

Joan Busfield (n.d.) explores the pharmaceutical industry as a source of rising health costs. She identifies a few different issues. One of these is the monopoly that pharmaceutical companies have over the drugs they develop, which lasts 20 years and is designed to allow them to earn back the cost of drug development. Another issue that pharmaceuticals are overprescribed -- one of per month for everybody in the developed world. While drug makers earn high profit levels in the west, developing nations are under pressure from bodies like the World Trade Organization to accept Western standards for intellectual property rights, which would force firms in the developing world to produce old, generic products almost exclusively, or pay licensing fees that would put those products out of reach pricewise for most of the people in those countries.

Busfield in particular calls attention to the lack of study regarding pharmaceuticals as consumer products, despite the size of the world's largest pharma companies and their influence of global social outcomes. She seeks specifically to call attention to the power and influence of the pharmaceutical industry in public and political discourse, and policy-making. She notes that while some within the industry complain about the costs associated with drug-testing for approval, many aspects of the process are designed to serve the needs of industry, rather than consumers.

Abraham (n.d.) postulates the idea of "pharmaceuticalization," which he defines as "the process by which social, behavioral or bodily conditions are treated…with pharmaceuticals" (p.290). He argues that the political economy of the pharmaceutical industry, consumerism and deregulatory state ideology are all contributing factors, interrelated, that drive the commercial success of the pharmaceutical industry. Abraham's overarching point is that these factors, more than medical necessity, are what have driven the increased use of pharmaceuticals and therefore health care costs.


The FDA has a multi-stage process by which it approves new drugs. This process, in general, takes several years and hundreds of millions of dollars to bring a product to market. Most new products that begin this process never reach FDA approval, meaning that they never come to market. For pharmaceutical companies, there is little incentive to invest in drug development in a totally free market, because after spending this time and money to develop a drug they would see competitors isolate the chemical composition of their work and replicate that drug within months or even weeks. The solution to this issue is the monopoly.

The monopoly is basic economics -- without competition, the firm can set its prices wherever it feels it will gain the highest profits. The pharmaceutical companies receive a 20-year monopoly on new drugs, which they view as an opportunity not only to recoup the cost of developing that drug, but the costs associated with developing other drugs that did not make it through the approval process, plus a profit margin on top of that. These are paid by the federal government through Medicare and Medicaid, and by insurance companies. In other words, these… [read more]

Opportunity to Work Essay

… When the artists or musicians needed me to attend to specific individuals, I would do that. It allowed me to learn the names of all the people in the facility. I also provided institutional support, and filled out forms for the therapists. This greatly helped their procedural operations, and dealt with the bureaucratic red tape that they did not like to do themselves. The process was painless for me, and I enjoyed being able to help.

Another way I provided service to the therapists and to the institution was during the occupational therapy and physical therapy sessions, such as the ones that Brown (1999) describes. During the occupational therapy sessions, we worked with many seniors who had mobility issues or mental impairment issues related to senility, dementia, or Alzheimers disease. These individuals needed extra support, which is what I provided in terms of holding their hands, or helping them walk around. We worked on issues such as how to send their grandchildren emails, and how to remember to take their medications. There are a lot of daily medications for the seniors, and the nurses on staff needed someone to bring the medications to the seniors. Many of them would protest the medications, but I was there to help the nurses when the individual became belligerent about taking it.

During physical therapy classes, I took a more hands-on approach. I have no personal experience or background in physical therapy, but I seemed to have a knack for it. When the therapist needed someone to help with specific exercises, I was there. I was able to hold up the individual when necessary, and work on motor skills. We worked with several different technologies and devices during the physical therapy sessions. The experience highlighted much of what I have learned throughout my course of study, especially in the area of nursing home therapies.


Brown, J.G. (1999). Physical and occupational therapy in nursing homes. Retrieved online: http://oig.hhs.gov/oei/reports/oei-09-97-00122.pdf

Therapy Dogs International (n.d.). Retrieved online: http://www.tdi-dog.org/OurPrograms.aspx?Page=Nursing+Homes… [read more]

Chest Pain the Presenting Patient Case Study

… Chest Pain Case Study

The presenting patient in the present case scenario is Mr. Hay, an 82-year-old male with an existing diagnosis of Cardiac Obstructive Pulmonary Disease (COPD). This existing diagnosis will prove relevant in a care plan for Mr. Hay, who has been admitted following a loss of consciousness. Having been discovered by a neighbor after some sustained period of unconsciousness, Mr. Hay would be admitted with an array of treatment issues. The three most pressing would prove to be the patient's Activity Intolerance, his Ineffective Airway Clearance and his Pain management. The discussion here below considers these treatment challenges.

Patient Problem 1: Activity intolerance

In any case where an elderly patient is admitted to the hospital, sedentary conditions can lead to an exacerbation of existing illness or to the formulation of new and problematic health concerns. This is especially true for the patient for whom excessive activity may produce negative health consequences as well. This is the case for the Mr. Hay, whose vital signs demonstrate the need for light but regular activity engagement.

For Mr. Hay, several factors are responsible for his activity intolerance and must therefore be accounted for even in the stimulation of activity. First, the fall caused by the patient's loss of consciousness has produced injuries to hip, ankle and shoulder. These injuries are likely to be an obstruction in the patient's attendance of daily physical engagement.

Additionally, the symptoms of Mr. Hay's COPD present a distinct challenge to ambulatory behavior. Shortness of breath, to be addressed in greater detail in the section below, may lead to dizziness, fatigue or disorientation and must therefore be monitored closely during the engagement of physical activity. Likewise, all evidence points to a mounting cardiac issue -- in all probability related to the existing COPD diagnosis -- that must itself be managed with care. Any physical activity must be offset by recognition of the patient's immediate cardiac state. The patient's heart-rate is recorded at 106 beats per minute (BPM). This is high relative to the normal rate of 60 to 100 BPM. This is consistent with MRIs showing the patient's moderately enlarged heart and a blood pressure reading placing the patient in the hyptertension risk index with a reading of 160 over 95.

These conditions collectively produce an intolerance to physical activity that must be managed and overcome in order to protect the patient from the danger of physical decline that may accompany hospitalization. The condition calls for assisted, light physical ambulation several times a day with constant monitoring of vital signs for indications of over-stimulation.

Patient Problem 2: Airway clearance, ineffective

The second problem of pressing importance is the patient's airway clearance difficulties. Here, a range of presenting symptoms suggest a worsening of Mr. Hay's COPD. The patient has experienced and, at the time of admission, continued to experience, respiratory difficulty. The patient's pursed lips and shallow breath suggest that he is struggling to breathe without assistance. Having performed medication reconciliation, caregivers have determined that the subject… [read more]

Treatments for Rosacea Research Paper

… One experiment tested how a topical lotion comprised of 0.1% kinetin lotion could treat Rosacea. Some patients with Rosacea do not handle topical creams well. This is because the condition causes the skin to be highly sensitive and creams can be highly uncomfortable for those patients. Unlike most creams, 0.1% kinetin lotion is extremely mild. The research conducted in this experiment showed that this type of lotion is better tolerated by Rosacea patients and can be used to help patients who cannot handle more aggressive topical treatments.

Some researchers suggest the taking of medication to treat Rosacea, including oral introduction of zinc sulfate into the body (Sharquie 857). In this particular study, patients were either given zinc capsules or placebos to determine if there was a marked difference in the results of the various patients. After the test was ended, the researchers were able to empirically show that the zinc sulfate capsules were an effective treatment for patients with Rosacea. This experiment shows a potential method of treatment for patients who are unable to tolerate traditional topical treatment types.

The research of scientists has shown a wide range of methods for treating Rosacea. Just as no two diseases are the same, so too no two patients are the same. Some people will do better with topical creams, others with light treatment, and still others through the taking of capsules. Each treatment has been shown to provide relief for certain Rosacea patients and so all are viable.

Works Cited

Lee, DH, Li, K.K., & Suh, DH "Pimecrolimus 1% Cream for the Treatment of Steroid-

Induced Rosacea: an 8-week Split-Face Clinical Trial." British Journal of Dermatology. (158:5). 2008. 1069-76. Print.

Papageorgiou, P.P., Clayton, W.W., Norwood, S.S., Chopra, S.S., & Rustin, M.M. "Treatment of Rosacea with Intense Pulsed Light: Significant Improvement and Long-Lasting Results." British Journal of Dermatology. (159:3). 2008. 628-32. Print.

Sharquie, K.E., Najim, R.A., & Al-Salman, H.N. "Oral Zinc Sulfate in the Treatment of Rosacea: a Double-Blind, Placebo-Controlled Study." International Journal of Dermatology. (45:7). 2006. 857-61. Print.

Wu, J.J., Weinstein, G.D., Kricorian, G.J., Kormeili, T., & McCullough, J.L. "Topical Kinetin

0.1% Lotion for Improving the Signs and Symptoms of Rosacea." Clinical &…… [read more]

Fall Prevention All Staff Falls Business Plan

… The use of bed and chair alarms can also be used to alert staff when a resident is getting up, especially a confused resident.

Staff rounding on a continual basis is especially important to monitor residents under fall precaution standards. Staff can monitor when residents are using walking aids improperly and work with residents to ensure the proper use for safety. Rounding can also monitor confused residents and prevent accidents that can cause injury. It can also assist residents who insist on maintaining their own independence, even though they have limitations that prevent them from being totally independent. Residents with mobility issues should always be walked and exercised by a staff member with the use of a gait belt for safety from falling.

Residents should be required to wear non-skid sole shoes at all times. Residents who are fall precaution require constant monitoring to ensure they don't try to do things, such as get up without assistance or reaching for items that are too far away, which can cause injury. Items the resident uses on a regular basis, such as water, should be kept in reach of coherent residents and water pitchers kept full where resident is not tempted to get up to meet the need of themselves. Wheel chairs should be well maintained at all times, with scheduled maintenance checks to ensure safety. All areas, including wheel chairs, should be kept clean to prevent hazards. This includes patient rooms, where items of clothing, trash, etc. can be on the floor that causes obstructions. Spills of any kind should be cleaned up immediately.

It is vital that all staff work as a team to ensure the safety of all residents. Regardless of what residents a staff member is assigned to, all staff members are responsible for keeping all residents safe. If a staff member is busy assisting one resident, other staff members need to answer call lights and make rounds on all residents to ensure safety and ensure that needs are met to reduce temptations in residents that are under fall precautions.


Falls in Nursing Homes. (n.d.). Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/HomeandRecreationSafety/Falls/nursing.html

Patient falls: How to prevent them. (n.d.). Retrieved from patient Safety Partnership: http://www.patientsafetypartnership.org/Patient_Falls.html… [read more]

Current Information and Communication Technologies Essay

… Healthcare Technology

The Bar Code Medication Administration System is a point of care software system for validating the correct medication is given to a patient in the correct manner (Weckman, 2009, May). It is designed to help prevent medication errors related to patient identification, correct medication, route, dosage, and timing. It contains user specified codes and electronic signatures that link to usernames.

A valid provider order is entered into the system, verified by a pharmacist, and made active. A nurse accesses the system using a specific code. The patient identification wrist band is then scanned with a handheld scanner. The nurse compares the scanner information to the wrist band, and then confirms the information is correct. A Virtual Due List appears, displaying allergies and medications due in the current time frame. The Virtual Due List is similar to a Medication Administration Record (MAR). If the nurse is administering other medications, the nurse is required to expand the Virtual Due List and record reasons for the other medication given.

The medication bar code is then scanned to confirm it is the correct medication, route, and dosage. If a patient refuses, is unable to take the medication, or medication becomes contaminated, the nurse can undo the action and mark it not given in the medication history. The Bar Code Administration System enables access to the medication list for nurses to check to determine when medications were given at past times. It also includes features of RN Clinical Reminders for PRN effectiveness documentation and abilities to access the Vitals Package where some medications require recent vital signs before administration.

If the Bar Code Administration System were more widely used, it could reduce the number of medication errors and adverse patient conditions that usually come about with medication errors. Nurses would be made more aware of mistakes in giving medication, especially in busy times when stress levels can become high. It would also give patients a higher assurance that measures are being taken to ensure safety in the medications…… [read more]

Human Papilloma Virus Vaccine Term Paper

… Monthly teleconferences and meetings were held by the workgroup thrice a year to review published as well as unpublished data related to HPV vaccine clinical trials along with data on efficacy, immunogenicity and safety of the vaccine. Moreover, data on… [read more]

Vitamin D In Controlling Urtis Article Critique

… al (2012) also gave the same results: 100000 IU of Vitamin D3 was not effective enough to control URTIs in healthy adults. The researchers also concentrated on changing their dosage and came to the conclusion that "result remained unchanged when the analysis included winter season or baseline 25-OHD levels" (Murdoch et.al, 2012). The findings of the experimental study are conclusive with literature. Similar experimental studies have been conducted by Laaksi et.al among 164 soldiers, for a dosage of 400 IU of Vitamin D3 (Murdoch et.al, 2012).

Validity and Reliability of the Research

Previous studies conducted had small samples. Study conducted by Murdoch et.al comprised of 322 healthy adults as they believed that the sample size could have an impact on the results, reliability and validity of the research. However, since the results were similar to previous studies, it should be noted that the reliability and validity of the research cannot be questioned. This is because the researchers had concentrated on collecting a large sample size to avoid any shortcomings. However, results were consistent with previous studies.

Murdoch et.al concentrated on studying the impact of vitamin D on URTIs and also asserted that there is a possibility that vitamin D might be able to control URTIs in other populations. In this regard, the authors have observed that "The mean baseline 25-OHD level was 29 ng/mL, and the mean level decreased to about 20 ng/mL during the winter in the placebo group; only 5 participants (1.6%) had baseline levels less than 10 ng/mL" (Murdoch et.al, 2012). The authors propose that such an effect may be found in populations, which suffers from deficiency of Vitamin D However, future research must be conducted in this regard. The internal validity of the research is valid and reliable as the sample size collected concentrated on collecting a large sample size as compared to previous studies. The results of the studies still demonstrated the outcomes of previous researchers and therefore internal validity cannot be questioned.


The limitation of the study was that the researchers did not evaluate the impact of Vitamin D in terms of preventing the disease, which occurred because of individual viruses. Data regarding this is insufficient and therefore, also requires future research (Murdoch et.al, 2012). Therefore, external validity of the research may be questioned.


Experimental studies have been conducted in order to understand the impact of vitamin D on controlling Upper Respiratory Tract Infections. The goal of Murdoch et.al (2012) was to study the impact of vitamin D on Upper respiratory infections (URTIs). The results from the experimental studies conducted to understand the impact of vitamin D dosage on VRTIs have given results, which conflict with one another and the findings of the research conducted by Murdoch et.al (2012) also gave the same results: 100000 IU of Vitamin D3 was not effective enough to control URTIs in healthy adults.


Murdoch et.al (2012). Effect of vitamin D3 supplementation on…… [read more]

Project Management, Sustainability and Whole Essay

… It is important to crosscheck the anti-inflammatory medications this patient receives with the antibiotics given for the urinary tract infection, as certain drug interactions can result in severe complications.

The patient suffering from bipolar disorder would appear to have no relevance to their direct patient care, unless proper medication dosages were not being adhered to, but this has not been an issue. The absence of teeth, while uncomfortable and a sign of advanced age, requires the assistance of a competent dentist and not a doctor.

As a direct patient care provider attempting to implement anatomical and physiological assessments into my overall diagnosis, in terms of the patient's long-term health prospects I would be most concerned about the presence of an irregular heartbeat. Considering the patient's advanced age, and the presence of hypertensive renal disease, suffering even the occasional occurrence of heart dysrhythmia could prove to be a life threatening event. It is well established that cardiovascular disease is a primary precursor to the end-stage renal failure which so often dooms those who suffer from chronic high blood pressure, and the subsequent hypertensive renal disease that ravages the kidneys. This patient must be encouraged to closely monitor the irregular heartbeat and report any issues promptly to direct care providers.

Works Cited

Christensen, Barbara Lauritsen, and Kockrow, Elaine Oden. Foundations of Nursing. New York, NY: Mosby, 2010. 434-472.…… [read more]

SOP Option 1: Envision Yourself Essay

… Although I enjoyed my time at the University of Chicago, I could see the boundaries and limitations of my education and those fences made me uncomfortable. I am a dreamer, someone who likes to look at the sky and perceive the endless potential of the universe. Thus, I chose a more challenging academic career at Northeastern University. The step was a huge one. I instantly felt the pressure to set goals and achieve them, for now I had something to prove. I was selected as one of a chosen few to maximize my potential as a budding biomedical engineer. I needed to show my peers and mentors what I was made of, and what I intended to do with my degree.

Now, of course, I can communicate my achievements in this book. But when I was still an undergraduate, I struggled to find a concrete way to develop my talents and skills. My work with Pi Mu Epsilon Mathematics Honor Society and the Biomedical Engineering Society meant that I surrounded myself with inspiring people. It was through meeting people at Northeastern that the spark of light shone in my own eyes: I was going to help the blind to see.

Continuing my studies in biomedical engineering at Northeastern, and receiving a graduate degree there as well, led me to interact with the greatest minds in my field. It was at Northeastern I developed the dream of Optics Wonder Lenses: the technology that would enable us to provide real eyes for real people. We gave the gift of sight to millions who had spent their prior lives in darkness. Our hard work and dedication at Northeastern translated into real tools and real action. If it was not for my reaching for the sky at Northeastern, I might never have been able to develop the biomedical tools that allow one new person each day to see the blue sky above them. This is my story. Thank you for reading it. If you are a recipient of OWL technology, thank you as…… [read more]

Government Be Allowed to Overrule Term Paper

… These instances included an 1853 British law that required vaccination against smallpox in England and Wales, The U.S. requires that children receive vaccination before entering public school. There are cases when individuals have free rights, but other times when the freedom of the individual has to be overruled. This is specifically so when the lives of many others are in the balance. Applying vaccinations is one of these instances.


American Medical Association (2000). Vaccines and infectious diseases: putting risk into perspective.


A Paralyzing Fear: The Story of Polio in America


A Paralyzing Fear: The Story of Polio in America [VHS] (1998): Reviews


Fiore AE, Bridges CB, & Cox NJ (2009). "Seasonal influenza vaccines." Curr. Top. Microbiol. Immunol.. Current Topics in Microbiology and Immunology 333: 43 -- 82.

Goldstein, M. (1978) How we know: an exploration of the scientific process New York: Plenum Press

Koplow, David A. (2003). Smallpox: the fight to eradicate a global scourge. Berkeley: University of California Press.

Lombard M, Pastoret PP &, Moulin AM (2007). "A brief history of vaccines and vaccination." Rev. - Off. Int. Epizoot. 26 (1): 29 -- 48.

Riedel S (2005). "Edward Jenner and the history of smallpox and vaccination." Proc (Bayl Univ Med Cent) 18 (1): 21 -- 5. PMC

PBS The Vaccine War


Wolfe R, & Sharp L (2002).…… [read more]

Drug Therapy Case Study

… Continual use of Ibuprofen should be crosschecked with Ms. Pharms medical history to avoid drug to drug interactions with the following medications: Aminoglycosides, anticoagulants, nitric oxide, diuretics, quinolones, antihypertensives, cardiac glycosides, lithium, methotrexate, ciclosporin, mifepristone, other NSAIDs, corticosteroids (MIMS Online, 2011).

Phenytoin, carbamazepine, theophylline, warfarin, oral contraceptives, antacids, sucralfate (MIMS Online, 2011) are the major sources of drug to drug interactions involving regular ingestion of Lansoprazole.

When considering the risk of harmful drug to food interactions, Ms. Pharm would be well advised to avoid consuming foods cooked with garlic, as this common cooking ingredient may pose a risk of hypoglycemia when combined with Glimepiride (MIMS Online, 2011). Ibuprofen poses no serious risk of drug to food reactions, while Lansoprazole should not be taken in con junction with a diet high in spicy or acidic foods.

3.) Discuss six (6) adverse medication reactions of the prescribed medications.

For patients taking a regular regimen of Glimepiride, expected side effects can include nausea, dizziness, diarrhea, and unusual bruising or bleeding (PubMed Health, 2011). The majority of Glimepiride's known side effects are gastrointestinal in nature, and if symptoms such as "hypoglycemia, GI upset, skin reactions & #8230; hepatic function abnormalities, hepatic failure, hepatitis, jaundice, blood dyscrasias, or transient visual disturbances" (MIMS Online, 2011) occurred in the case of Ms. Pharm, I would advise her to immediately discontinue use in favor of alternative treatment.

Ibuprofen has been known to cause adverse medication reactions when combined with "aminoglycosides, anticoagulants, nitric oxide, diuretics, quinolones, antihypertensives, cardiac glycosides, lithium, methotrexate, ciclosporin, mifepristone, other NSAIDs, corticosteroids" (MIMS Online, 2011). Because patients with a "history of, or active peptic ulcer & #8230; aspirin/anti-inflammatory allergy & #8230; or severe heart failure" (MIMS Online, 2011) can experience gastrointestinal hemorrhaging, Ms. Pharm's current gastritis condition poses a significant risk and as her nurse I must control her dosages of both drugs with professional precision.

Lansoprazole reacts harmfully when taken in conjunction with "phenytoin, carbamazepine, theophylline, warfarin, oral contraceptives, antacids, sucralfate" (Tiziani, 2010, 396), and again the fact that Ms. Pharm regularly takes an antacid necessitates close and careful monitoring of her drug ingestion to prevent complications.


MIMS Online Database. (2011). Glimepiride. Available: http://www.mims.co.uk/Drugs/diabetes/oral-and-parenteral-hypoglycaemics/glimepiride/. Last accessed 24th Oct 2012.

MIMS Online Database. (2011). Ibuprofen. Available: http://www.mims.co.uk/Drugs/pain/pain-fever/ibuprofen/. Last accessed 24th Oct 2012.

MIMS Online Database. (2011). Lansoprazole. Available: http://www.mims.co.uk/Drugs/gastrointestinal-tract/peptic-ulcer-z-e- syndrome/lansoprazole/. Last accessed 24th Oct 2012.

Tiziani, A. (2010) Harvard's Nursing Guide to Drugs. 8th ed. Sydney, Australia: Elsevier- Mosby

PubMed Health Online Database. (2010). Ibuprofen. Available: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000598/. Last accessed 24th Oct 2012.

PubMed Health Online Database. (2011). Glimepiride. Available: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000981/#a696016-sideEffects. Last accessed 24th Oct 2012.… [read more]

Bacteria Pseudomonas Annotated Bibliography

… The conference included many different notable researchers who have been looking at the issue of waterborne bacterial infections in hospital settings. This is particularly concerning due to the increase in patients who have secondary infections after hospital stays. The conference looked at the prevalence of waterborne pathogens, where they come from and methods that have been used to mediate them.

The various lectures at the conference are summarized for the reader which makes this a particularly useful article. Since waterborne infections are among the major problems discussed in the articles gathered (this pathway seems to be one of the most common for the transference of pseudomonas aeruginosa), this article gives more information about how this problem is conveyed than any other. It is a seminal article in that it is a type of meta-study which looks at the problem from many angles and through the research of many different experts. It is, again, a foundational article to the research being conducted.

This particular article provided more understanding of the overall concept being research and gave direction to the study of the pseudomonas bacteria. Even though the article only discusses waterborne infections in hospitals, it gives information on the danger and spread of the bacteria in other areas also. The methods that the various researchers use to stop the spread of the bacteria is also valuable.

Stein, R.A. (2011). Antibiotic resistance: A global, interdisciplinary concern. American Biology Teacher, 73(6), 314-340.

The facts presented in this article are essential knowledge for the underpinnings of any article which discusses the resistance of bacteria to antibiotics. The author begins his discussion when antibiotics were first discovered and points out that resistant strains of bacteria were already present when penicillin was first commercially introduced. Throughout the years, as more and more types of antibiotics have been introduced, bacteria have evolved methods of combatting the agents that are deadly to them. The author looks at the different products invented by medical scientists for producing antibiotics, and the methods the bacteria then use to overcome their effects. It is a very thorough article which provides a history of the problem, and looks into the development of pseudomonas resistant strains as well as others.

This article provides the ability to look at how bacteria have developed over time and how the means of protecting against them have also evolved. This article is necessary to the research because it describes, in detail, how bacteria become resistant and how antibiotics have been manufactured to overcome the resistance. It is necessary to understand how the bacteria work so that the process can be explained.

This article was probably the most informative regarding the entire history of the battle between bacteria and antibiotics. It provided insights which other articles…… [read more]

Tennessee H1N1 Issues in Healthcare Response Case Study

… Tennessee H1N1

Issues in Healthcare Response: Tennessee and the H1N1 Flu Outbreak of 2009

Coordinating responses to impending epidemics is not always easy, especially when a great deal of that preparation depends on the availability of a vaccine that has… [read more]

Hypomagnesemia Fact Sheet Essay

… Laboratory Evaluation

It should be noted that "Mg deficiency should be suspected even when serum Mg concentration is normal in patients with unexplained hypocalcemia or refractory hypokalemia




Initial treatment includes supplementation with magnesium. However, the underlying problems must be addressed that lead to the deficiency. Patients may need to undergo treatment for alcoholism or have their medications readjusted.

Expected outcome and follow-up needs

Expected outcomes depend upon the severity of the case, and will determine the course of treatment. In most, less severe cases, oral Mg salts are an adequate to restore balance to the body. In more severe cases, "when Mg deficiency is symptomatic or persistently < 1 mEq/L (< 0.50 mmol/L) an IV or IM of Mg sulfate may be required" (Lewis 2009). This may be also used for alcoholics who cannot be relied upon to follow oral administration guidelines.

Patient education

Patient education is highly dependent upon the causes of the deficiency. Patients taking medications or who have illnesses which may present the risk of an Mg deficiency must be educated as to the signs so they can engage in self-monitoring; so must their caregivers. Patients whose lifestyles put them at risk must receive support to prevent reoccurrence.


Lewis, James. (2009). Disorders of Magnesium concentration. Merck Manuals. Retrieved:

http://www.merckmanuals.com/professional/endocrine_and_metabolic_disorders/electrolyte_disorders/disorders_of_magnesium_concentration.html… [read more]

Confidentiality Hospital and Confidentiality Rct Case Study

… Patients are likely to be willing to take a risk to improve their chances of extending their life spans.

Regarding the first aspect of Dr. L's dilemma, little utilitarian benefit would accrue if the doctor broke his confidentiality and informed Bruce W. Of the fact Bruce was taking a placebo. At best, Bruce would feel anxious and upset to know he was getting no real treatment and this would likely compromise the effectiveness of the study, since Bruce would perceive no benefits and not act as an effective control in the study. The placebo effect has been measured and is 'real,' and must be taken into consideration when comparing the results in the experimental group and the control group, and Dr. L secretly coming forward will merely taint the results. Whatever the ethical obligation he perceives towards his patient, he knew when the patient agreed to the trial the doctor knew he would be ethically bound not to inform Bruce of his status as a control group participant.

The court case of Tarasoff v. Regents supports the philosophical notion in ethics that there must be a balance between the rights of individual patients and the collective needs of society in medical decisions (211). However, regarding his larger dilemma Dr. L is within his rights of talking to the study designers about discontinuing the study and allowing all participants to benefit from the drug. In this particular example, the RCT is fairly small and it is still difficult to draw definitive conclusions from this singular analysis of the small group. More extensive trials will likely be warranted and the drug is still in its developmental stages. However, it may be possible, given the nature of the disease, to do more extensive studies that are quasi-experimental in nature and allow for a wider proportion of the subjects to benefit from…… [read more]

SWOT Analysis: Bristol Myers Squibb SWOT

… Due to these generic drugs the pharmaceutical companies invest heavily in their research and development program so that they can always have a marketable drug before the generic ones hit the market. Bristol-Myers Squibb has a strong pipeline but the drugs they have in their pipeline have to compete with other drugs that were introduced in the market earlier than theirs, and this puts the company at a disadvantage as it is not able to boost its commercial potential.

Another weakness faced by Bristol-Myers Squibb is to get FDA approval on their new drugs. The company invest a lot and does a series of tests before they can forward the drug for FDA approval and if the drug fails to be approved the company incur a lot of losses. Though this does not happen often, when it does it has far reaching consequences and affects the overall performance of the company.


Bristol-Myers Squibb is currently investing in development for health products that would be used for areas that the medical needs have not been met. The company does this to have the grace period of market exclusivity. During this period, the company is better placed to sell its drug and eventually break even thus gaining the investment it had put in and also get profits. With these kinds of strategies, the company can rest assured they would have a product in their pipeline at any one given time that would have market exclusivity. The company should also ensure they have a strong and well funded Research & Development program, which would be strategically positioned in order to produce drugs that would be a huge success for…… [read more]

Long-Term Care Facility Safety: Prevention Case Study

… A study conducted by Hartikainem, Lonnroos and Louhivuori (2007) examined whether medication put the older individual at a risk for falls. The study is reported to have concluded "that central nervous system drugs, especially psychotropics, seemed to be associated with an increased risk for falls." The elderly person's individual physiological factors also result in an increased risk for falls.

Koski, Luukinene, Laippala and Kivela (1996) report that conditions that place the older patient at a higher risk for falls include "lower-extremity muscle weakness, peripheral neuropathy, lower pulmonary capacity, difficulties in gait and use of long acting benzodiazepines and cardiovascular medications." Additionally noted is that the primary occurrence of falls was when the older individual was either "walking or taking a seat" and it is stated that this indicates "training of lower extremities and supervised walking could be an effective nursing intervention for elderly clients." (Koski, Luukinene, Laippala, and Kivela, 1996) Individual Risk Factors that are modifiable and non-modifiable and the environmental risk factors for falling that are modifiable and those that are nonmodifiable are stated by the Long-Term Care Imperative as follows:

Individual Risk Factors

Non-Modifiable Modifiable

Older Age Muscle Weakness

Female Gait and Balance Problems

Chronic Diseases Vision problems

Mentally Impaired Psychoactive medications

Environmental Risk Factors

Non-Modifiable Modifiable

Cold temperatures Clutter in walkways

Uneven pavement No stair railings or grab bars

Poor public space designs Loose rugs

Dim lighting

Source: The Long-Term Care Imperative

It is noted by Premier Inc. that a comprehensive program is needed to reduce falls including the following:

(1) Assessing and screening for risk factors for falls.

(2) Using triggers to implement a falls prevention protocol.

(3) Implementing protocols according to patient needs.

(4) Assessing and reassessing patient and modifying as appropriate.

(5) Reporting falls (internal and external).

(6) Measuring/monitoring fall rates.

(7) Improving the falls prevention program.

Additionally reported is the fact that it is not possible to have a routine fall prevention program since falls occur in many different situations for older adults therefore the prevention plan should be individualized for each patient.


Comprehensive Prevention Program (2012) Premier Inc. Retrieved from: https://www.premierinc.com/quality-safety/tools-services/safety/topics/falls/prevention_program.jsp

Falls Among Older Adults: An Overview (2012) Centers for Disease Control and Prevention. Retrieved from: http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html

Koski, K., Luukinen, H., Laippala, P., & Liisa-Kivela, S. (1996). Physiological factors and medications as predictors of injurious falls by elderly people: A prospective population-based study. Age and Ageing, 25: 29-38.

McCarthy, R. Adedekun, C and Fairchild, R. (nd ) Preventing Falls in the Elderly Long-Term Care Facilities. RN Journal. Retrieved from: http://www.rnjournal.com/journal_of_nursing/preventing_falls_in_the_elderly_long_term_care_facilities.htm

McNamara, C. (1998). Basic guide to program evaluation. Retrieved November 9, 2009 from http://www.managementhelp.org/evaluatn/fnl_eval.htm

Sherrington, C., Whitney, J.C., Lord, S.R., Herbert, R.D., Cumming, R.G., & Close, J.C. (2008). Effective exercise for the prevention of falls: A systematic review and meta-analysis. Journal of the American Geriatric Society, 56(12):2234-2243. Retrieved on September 30, 2009 from http://www.medscape.com/viewarticle/585681

The American Medical Directors Association. (2005). Falls and fall risk. Assisted Living Consult. Retrieved on November 8, 2009 from http://www.assistedlivingconsult.com/issues/01-01/ALC1-1_FallsRisk.pdf

Wandering and Elopement (2012) NCCDP LLC. Retrieved… [read more]

Consent of Subjects Research Paper

… Identification of all parts of the trial that are experimental

F. Description of any foreseeable risks or discomforts to the subject

G. A description of any benefits to the subject or others that can be expected from the research

H. A disclosure of appropriate alternative procedures or courses of treatment that might be advantageous to the subject

I. A statement describing the extent of confidentiality of records and notes that the FDA may inspect records

J. Explanation of any compensation any potential injury that may occur and where further information may be obtained

K. Explanation of subjects rights and whom to contact in the event of a research-related injury

L. A statement that participation is voluntary and refusal will result in no penalty.

Some additional elements may be appropriate for the ICF of clinical trial depending on circumstances and may include the following (21CFR 1998):

A. A statement that the particular treatment may involve risk to the subject or fetus should the subject be or become pregnant

B. Circumstances under which the subject's participation may be terminated by the investigator without the consent of the subject

C. Any additional costs to the subject that may result from participation in the research

D. The consequences of a decision by the subject to withdraw from the research

E. The approximate number of subjects involved in the study

The investigator should provide a signed and dated copy of the approved ICF to each subject with any supplemental documents or amendments to the information prior to and during participation in the research.

The understanding of the material in an ICF should be written as if a teacher were providing an oral explanation to a subject. For example, it is easier to review and determine the role and specifics if the subject is addressed as "you" and the members of the investigational team as "we" as it helps to communicate that a choice can be made by a subject. The use of legal waiver terms such as "I understand" or "I have reviewed and been explained" should be avoided as a subject may not be in a position to evaluate whether or not they understand. Scientific and medical terms should be explained to place emphasis on legitimate risk within the procedure and should be described in such a way that a student with no subject matter expertise can see that the procedure both has a purpose and could pose a risk that can be evaluated against the subject's own standards. Complicated biomedical and research terms must be avoided. If it is not possible to concisely explain the procedure and risks and benefits to the subject due to the subject's lack of comprehension and a suitable authorized legal representative is not present then the investigator must determine that it is not possible to obtain informed consent and the patient must be excluded from the trial.


Protection of Human Subjects, 21 C.F.R. § 50 U.S. FDA (1998)

E6…… [read more]

Justification: Assessment of Proteome Changes in Model Research Proposal

… ¶ … Justification: Assessment of Proteome Changes in Model Bacteria in Response to Antibiotic Treatment Using Combined Mass Spectrometry and Bioinformatics Techniques

The following research proposal describes the investigation of proteomic changes in a model bacteria after exposure to a… [read more]

Report on Antibiotic Resistant Bacteria Essay

… Antibiotic Resistant Bacteria

The Prevalence and Threat of Antibiotic Resistance Bacteria

The rate at which bacteria are becoming resistant to drug treatments that are intended to eliminate or weaken them is growing rapidly. For over half a century, antibiotic drugs… [read more]

Drug Company Perks as a General Rule Article Critique

… Drug Company Perks

As a general rule, it is problematic to accept valuable gifts from people trying to solicit your business because it is believed that those gifts will influence decision-making. This influence is well understood by the sellers; they would not be offering gifts or perks if they did not have a sincere belief that doing so makes the sale more likely. However, that does not mean that they are believed to be bribes by the sellers. Instead, the sellers may simply believe that these perks help make the potential purchasers more amenable to the sale. In fact, the perks might actually be the only way that the salespeople have the opportunity to present their information to the clients. Therefore, I am not certain that it is always problematic to accept low-value gifts from people who are trying to solicit business, but I am certain that it would be problematic to accept high-level gifts from those people. Is the gift large enough to induce the buyer to give the seller time to make a presentation? If so, then I do not believe that the gift is necessarily unethical. However, if the gift is large enough to influence decision-making beyond allowing an opportunity for a presentation, I can see some ethical problems.

One of the main issues with pharmaceutical companies offering gifts or perks to physicians is that the physicians are not making purchasing decisions for their offices. if, for example, their supplier for scrubs or manila envelopes wanted to provide them with lunches and free sticky notes, it seems difficult to suggest that would be an ethical issue. However, when doctors are making decisions about prescribing medications, they are not making purchasing decisions for themselves; instead, they are making health decisions for their patients. Moreover, patients who receive prescriptions from their doctors believe that those doctors are prescribing medications based upon the symptoms and complaints presented by the patients combined with the doctor's underlying medical training. Therefore,…… [read more]

International Drug Firms Assessment

… ¶ … changing market demographics and related factors in foreign countries continues to be an important issue for major pharmaceutical companies. More specifically, the largest drug companies headquartered in the so-called "First World" have learned to by somewhat shy of the international market in less developed poorer nations, largely because the latter do not offer the same degree of patent protection as wealthier more developed nations. However, pharmaceutical companies are beginning to re-evaluate that concern for several reasons.

Authors Point-of-View:

The author acknowledges the traditional (albeit learned) bias against marketing proprietary pharmaceutical formulations in poorer nations that do not offer patent protection comparable to those available in the wealthier nations where such drugs are typically developed. On the other hand, the author suggests that this apprehension is undergoing a change on the part of pharmaceutical companies for the following reasons: First, the growth of the economies, and therefore, the middle classes in poorer nations presents a potentially lucrative market that drug companies may have a difficult time resisting. Second, market growth in the wealthier nations has slowed, substantially because of increasing competition from the sale of generic drugs and also because of increasing government legislation and controls that limit prices and profits on pharmaceuticals in those countries. Third, pharmaceutical companies are beginning to realize the extent to which the populations of underdeveloped nations actually represent potentially lucrative markets.

In that regard, the author makes the important point that, to date,…… [read more]

Speech Understanding Ototoxicity Characteristics Research Paper

… The sound stimulus is presented in the ear contralateral to the probe tip. A continuous pure tone stimulus is presented 10 dB above acoustic reflex threshold for 10 seconds. The test is positive if the magnitude of the reflex decreases by more than 50% in ten seconds. In a normal ear, the reflex should stay contracted for the full 10 seconds. Note, the ear being tested is the one receiving the stimulus not the probe (Dille 2010).

Otoacoustic Emission -- The purpose of this test is to determine cochlear status, specifically hair cell function. This information can be used to: 1) screen hearing, particularly in neonates or individuals with developmental disabilities, 2) estimate hearing sensitivity, 3) differentiate between the sensory and neural components of sensorineural hearing loss, and 4) test for functional (feigned) hearing loss. The information can be obtained from patients who are comatose because no behavioral response is required (Campbell 1993; Rybak 2007)

Auditory Brainstem Response - This test is similar to ARD as it also is a screening method to rule out acoustic neuromas or vestibular schwanomas of the eighth cranial nerve. The test is performed by generated an evoked potential by a brief click or tone transmitted from a transducer in the form of an insert earphone. The elicited response is measured by surface electrodes typically placed on the scalp and ear lobes. An abnormal ABR finding is suggestive of retrocochlear pathology and indicates the need for MRI to look for abnormalities (Roland 2004).


Ototoxicity is a pernicious but entirely preventable disease. It is a result of antibiotic and anti-neoplastic medications. The damage it does affects the auditory and balance systems and can result in hearing loss, tinnitus, disequilibrium or dizziness. Numerous audiometry tests exist to localize the degree of hearing loss, the type of hearing loss and the location of the pathology. Furthermore, they can be used to exclude other sources of pathology such as acoustic neuromas. These tests can guide treatment options in regards to the need for hearing aids, physical therapy and cochlear implants. In regards to recommendations to clinicians, I would strongly suggest avoiding ototoxic medications or medication combinations whenever possible. If the need arises due to infectious or malignant disease, it is advisable that strict monitoring of a patient's hearing be implemented. I would recommend tests that analyze both conductive and sensorineural hearing loss as well as exams which will out other phenomenon such as acoustic neuromas. Lastly, I would advise patients to actively engage in physical therapy to maximize their remaining acoustic function (Campbell 1993; Roland 2004; Fausti, 2009)


Campbell KC, Durrant J. (1993) Audiologic monitoring for ototoxicity. Otolaryngol Clin North Am. 26(5): 903-14.

Dille M., et al. (2010). Ototoxicity risk assessment combining distoration product otoacoustic emissions with a cisplatin dose model. J. Of the Accoustical Society of America. 128(3): 1163-1174.

Fausti S., et al. (2009). Auditory and vestibular dysfunction associated with blast-related traumatic brain injury. Journal of Rehab Research and Development. 46(6): 797-810.

Grant KW, et al.… [read more]

Roberts Et Al. ) Deals Research Paper

… (2008) wondered whether a robotic dog would have the same impact on reducing loneliness, as would a live dog.

Residents of 3 different long-term care facilities were employed in this study. Three levels were used in this experiment -- a group that had living dogs; a group with robotic dogs; and a control group that received no animal-assisted therapy altogether. The independent variable was the dog -- either live or robotic. The dependent variable was the loneliness tested by a loneliness scale.

The comparison of the means between two groups (real dog and robot) was tested by a t-test, whereas the comparison between all 3 groups (real dog; robot; and control) was tested using an ANOVA followed by the Newman-Keuls range test whose objective is to look at all the pairs of means in order to see whether there is a differnce between them.

Results showed that in comparisons with the group that received no animal-assisted therapy, both groups of dogs (robotic and real) showed significant reduction in loneliness. A modified Lexington Attachment to Pets Scale (MLAPS) showed that individuals of both groups showed high attachments to their respective dogs.

Correlation and regression statistics (in order to assess whether loneliness reduction was associated with the animal-assisted therapy) showed that the MLAPS measures were not associated with any changes in loneliness, indicating that whilst both real and robotic dogs seems to decrease loneliness in residents, it is not the essence of animal-assisted therapy that does it but some other unknown variable and that the exact mechanism by which loneliness is reduced as a results of the pets is still unclear.


Banks, MR et al. (2008). Animal-Assisted Therapy and Loneliness in Nursing Homes: Use of Robotic vs. Living Dogs American Medical Directors Association, Origianl Studies, 173-178

Robert MS et al. (1998) Medication…… [read more]

Health Immunizing Your Baby Research Paper

… Inherent in these discussions is the issue of whether or not all lives are of equal value, and evenly deserving of opportunities to be protected by vaccination (Ethical Issues and Vaccines, 2011).


There is no denying the fact that vaccines have been a good thing over the years. There are many deadly diseases that our ancestors had to fear that today are not given a second thought. On the other side of the coin there have been some studies that have claimed to find a link between these vaccinations and other disorders like autism. In the end parents must educated themselves in order to make sure that they make the right decision when it comes to immunizing their children. In a study done by Tarrant and Thomson (2008), parents readily admitted that they had knowledge discrepancies in regards to childhood vaccines but believed that the benefits of immunization overshadowed any risks that might be present. The biggest source of information for these parents was family members and peers. Along with this information wide-ranging public health programs and mandatory vaccination requirements for school entry made certain that childhood immunization recommendations were followed.

At the present time there does not appear to be enough sufficient evidence to recommend that children not be vaccinated. The benefits of having a child vaccinated clearly outweigh any possible harm that the vaccinations might be causing. Children should continue to be vaccinated according to the schedule that has been set down by the CDC, so that everyone can be protected.

Works Cited

Carolyn Drews-Botsch, et al. "Timeliness of Childhood Immunizations: A State-


Analysis." American Journal Of Public Health 95.8 (2005): 1367-1374. Business


Premier. Web. 22 Nov. 2011.

"Childhood Vaccinations: Understanding Vaccines." Practice Nurse 31, 9-13 (2006)

Business Source Premier. Web.…… [read more]

RFP Request for Proposal Procedures Statement Term Paper


Request for Proposal Procedures

Statement of Acknowledgement and Proposal Procedure

RFP Instructions and Project Background

Applicant Company Overview

Product and Services

Technical and Operational Design Requirements

F. Response Sheet

Statement of Acknowledgement and Proposal Procedure

The Fulton County Health Department requires one (1) printed original, signed in BLUE ink, one paper copy and 1 (one) CD ROM. These are to be submitted in a sealed enveloped bearing an assigned Control Number to be located on the first page of the RFP document and sent to the following address:

Fulton County Health Department

Malone St. SE, Fairburn, GA 30213

The deadline for the submission of proposals to the County Health Department Secretary's Office is no later than Wednesday, June 8, 2012 at 2:00 P.M. Any failure to submit the require number of copies may result in disqualification from consideration.

Respondents may either mail, or personally deliver, their submissions to the County Health Department Secretary's Office.

4. The RFP must be signed to bind the Submitter(s).

B. RFP Instructions and Project Background

The County seeks to expand upon the availability of immunization services in the network by expanding the availability of these services in its facilities. It seeks to improve and expand upon the availability of immunization services in the network by expanding the availability of immunization services in Fulton County facilities.

The local immunization database registry for the physician's office must be compatible with the GRITS, state-based system in Georgia (GDPH, 2011). It must contains a minimum of patient name, date, age, ethnicity, address, phone number, public or private, the date of the vaccination, the type of vaccination, manufacturer information, public or private stock, dosage of vaccination, fields for adverse reactions, advice for subsequent modifications, allergies, and immunity gained through…… [read more]

Gardasil HPV Vaccine Pros Cons Term Paper

… Gardasil

An Analysis of the Pros and Cons of Gardasil as a Vaccine for HPV

Gardasil, a new vaccine developed by Merck & Co., was approved in 2006 by the U.S. FDA as a preventative vaccination for HPV (human papillomavirus… [read more]

MRSA a Communicable Disease Research Paper

… MRSA -- a Communicable Disease

Hospital-acquired infections cause a major concern that threatens patient treatment, hospital staff, and community health. The article presented by Sarah Fairclough highlights the hazard of methicillin-resistant Staphylococcus aureus (MRSA) as it responsible for one-fifth of all hospital-acquired infections, and represents a significant problem in the medical community (2006). The threat of MRSA infections is severe as MRSA is growing in treatment resistance to antibacterial medications, and Fairclough describes rationale behind resistance in these stains. Hospital-acquired infections, such as MRSA and antibiotic resistant stains of MRSA, lengthen hospital stays, cause significant morbidity, affects nurses' workloads, and can introduce new infections into the community (Fairclough, 2006). Eradicating MRSA seems to be impossibility, however attempts to control the spread of MRSA are encouraged by Fairclough as giving attention to the following factors: detecting and isolating infected or colonized patients, rational antibiotic prescribing, hand hygiene and cleanliness. Taking these measures will not eliminate MRSA, but a comprehensive approach to reduce the risk of MRSA infection is required to decrease its rate of incidence and mortality.

Accounting for 20% of all hospital-acquired infections, MRSA affects the health of patients, the threat of infection within a community, and the workload of nurses and medical personnel. The increased resistance to antibacterial treatments intensifies the risk of MRSA infection, and Fairclough, like many other professionals, describe the resistance as a consequence of evolutionary action (2006). Health administrators are urged to recognize the reproductive cycle of bacteria as much shorter than humans, and therefore bacteria able to adapt to hostile environments (in this case, antibacterial medication) faster, and increases the rate of resistant infections (Fairclough, 2006). Bacteria that develop resistant traits then pass these traits to their offspring, resulting in antibiotic resistant strains of MRSA and other bacterial infections. The incidence of MRSA within the hospital setting is also reflected in the community. In the UK, common strains are found in the hospital and in the community, and could be explained by interactions between patients, visitors, and hospital staff (Fairclough, 2006). In the U.S., however, Fairclough explains different MRSA strains have initiated in the community,…… [read more]

Endocarditis, a Heart Condition Research Paper

… Those that do have these risk factors are encouraged to use a series of antibiotics to stay ahead of a potential problem (Levy, 2010).

This heart condition is serious and can lead to a myriad of complications, including stroke and organ damage, infections in other parts of the body and even heart failure (Mayo Clinic Staff, 2011). More specifically, other complications include blood clots that can travel to the brain, kidneys, or lung, a brain abscess, jaundice, neurological changes or even stroke (Levy, 2010). The complications are grave and serious and have certainly warranted clinical trials, specifically by the National Heart, Lung and Blood Institute (NHLBI). The clinical trials have led to advances in medical knowledge and care (U.S. Department of Health and Human Services).

The clinical trials have led to many diagnostic tests that can help in the diagnosis process include blood tests, transesophageal echocardiogram, an electrocardiogram, a chest X-ray, or using a CT or MRI scan (Mayo Clinic Staff, 2011). Treatments for endocarditis include antibiotics, and if the conditions is more severe, surgery (U.S. Department of Health and Human Services). Antibiotics usually are given for two to six weeks through an intravenous line inserted into a vein (U.S. Department of Health and Human Services). Surgery is utilized only in more serious cases in order to repair or replace a damaged heart valve or to help clear up the endocarditis (U.S. Department of Health and Human Services). Prevention is certainly important and The American Heart Association recommends preventative antibiotics and "continued medical follow-up is recommended for people with a previous history of infectious endocarditis" (Levy, 2010).


Levy, Daniel. (2010, May 7). Infectious endocarditis. Retrieved from http://health.nytimes.com/health/guides/disease/infectious-endocarditis/overview.html

Mayo Clinic Staff, Initials. (2011, August 11). Endocarditis. Retrieved from http://www.mayoclinic.com/health/endocarditis/DS00409

U.S Department of Health and Human Services, Initials. (n.d.). What causes endocarditis?. Retrieved from http://www.nhlbi.nih.gov/health/dci/Diseases/endo/endo_causes.html… [read more]

Abbot Labs Research Paper

… Abbott Labs

Problem identification: Mini business plan

Insufficient protection against problems inherent in healthcare industry

Unlike Johnson & Johnson, a firm which possesses many different kinds of personal care as well as medical and pharmaceutical product lines, Abbott Laboratories' product line is extremely concentrated in several specific areas of the healthcare field. When the economy is hard-hit, many people cut back on spending money on healthcare and focus their income on what they see as the most essential items. The types of personal care products that Abbott does possess include animal care and vision care products, which fall into the line of less necessary products than Johnson & Johnson's shampoos and baby care items.

One way to diversify further is to focus more upon its lines of nutritional products, such as Similac, Ensure, Glucerna, AdvantEdge, Body-for-LIFE and ZonePerfect (Products by category, 2011, Abbott Laboratories). These products are specifically designed to address the needs of people with diabetes or who wish to live a healthier and/or lower-carb lifestyle. As a leading provider of such personal care products to a growing world population of seniors and diabetics, Abbott could gain a competitive advantage over Johnson & Johnson and other personal care product providers.

Problem 2: Insufficient diversification of pharmaceutical products

Abbott's anti-inflammatory product Humira has gained it considerable market share. This anti-tumor necrosis factor (TNF) drug has shown considerably better performance than any of the comparable products of Abbott's competitors (Zacks analyst blog highlights, 2011, Yahoo). However, focusing too closely on one or two highly-desirable products can backfire as a strategy for a pharmaceutical company. First of all, given the rate at which drugs can 'go generic,' even the most successful pharmaceutical product is only assured of gaining astronomical profits for a finite period of time. Patents have a definite expiration date and when generic, cheaper medications are available, patients, insurance companies, and hospitals are more apt to choose the cheaper alternatives. Even…… [read more]

Pharmaceutical Ethics Issues Generally Research Paper

… In essence, it was one of many examples whereby the powerful corporate lobbyists and their hired technical experts managed to successfully persuade legislators on matters where their respective comprehension of the issues differed greatly and where the former achieved their goals by a combination of "incentives" and obfuscation of relevant issues that lawmakers are ill-equipped to decide based on their lack of fundamental understanding of the merits of the scientific arguments (Tong, 2007).

Finally, the influence of the pharmaceutical industry lobbyists on Washington lawmakers having to do with the lucrative practice of prescribing drugs for so-called "off label" uses either not approved or not yet approved by the Food and Drug Administration (FDA) is yet another example of this dynamic (Santoro & Gorrie, 2005). Currently, it is regulated only by a voluntary code of ethics established by the American Medical Association, no doubt, with the help and influence of pharmaceutical representatives (Santoro & Gorrie, 2005). Naturally, pharmaceutical companies are even les constricted in this regard in the global market than they are domestically in the U.S.


In many respects, the modern pharmaceutical industry has served an extremely valuable purpose furthering human health throughout the 20th century. There is no doubt that the development of many drugs have enabled the medical community in the First World to eradicate some of the worst diseases that had previously caused so much misery in human societies since antiquity. Initially, globalization enabled the populations inhabiting the less developed parts of the world to benefit from some of those important advances in healthcare attributable to pharmaceutical products. However, in the contemporary age of globalization, the pharmaceutical industry is insufficiently regulated to prevent the widespread exploitation of large patient populations, especially in the Third World. Even in the most advanced societies, pharmaceutical lobbyists have succeeded in corrupting the process of government legislation to further their financial interests, substantially at the expense of human health.


Beauchamp, T.L. And Childress, J.F. (2009). Principles of Biomedical Ethics, 6th

Edition. Oxford University Press.

Halbert, T. And Ingulli, E. (2009). Law & Ethics in the Business Environment. Cincinnati:

West Legal Studies.

Santoro, M.A. And Gorrie, T.M. (2005). Ethics and the Pharmaceutical Industry.

Cambridge, UK:…… [read more]

Should HPV Vaccination Article Critique

… HPV Vaccine

In Decision Scenario number one, a thirteen-year-old girl is about to transfer to a new school in a new state that has a mandated law to vaccinate all adolescent girls against the Human Papilloma Virus before being allowed to register for class or allowed to start school. Although it is a requirement for entrance to the school, the girl's father does not want her to have to get that vaccine because he feels it is unnecessary since she is not sexually active, nor is the vaccine researched enough to merit its usage so freely and mandatorily (Muson, p.103). The major moral issue at hand here is not that this vaccine is condoning sex before marriage, but that the young girl is not having a say in something that is going to directly affect her body (Richardson). Whose interest should be valued more? Is anyone allowing the young girl who will be having this vaccine injected into her to have an opinion on the matter? Who, in this situation, fully knows what is best for the thirteen-year-old girl? It is this issue that we shall analyze and distinguish the possible implications in effect.

The Human Papilloma Virus (HPV) vaccine is a relatively new development. With HPV's direct link to cervical cancer, it has become an issue of not only preventing an unfortunate illness, but also protecting someone before any chance of contracting this virus is even possible. HPV is a sexually transmitted disease, one that is so common, that doctors and vaccine producers are now directly recommending girls as young as 11 or 12 years to get this vaccine before any opportunity of contracting the virus is even possible (CDC). But whose best interest is at mind? One side of this argument can be supported by the fact that this is indeed protecting the girls who are being mandated to get this vaccine. By assuring that the adolescent girls get the HPV vaccines, doctors, parents, and any who will be involved if a mishap occurs will not have to worry about the possibility of anyone who has gotten the HPV vaccine to get HPV in the future. Although this is not allowing the girls to have a say in this issue that is directly affecting them, it is indeed providing them with some sort of protection from something that would eventually cause them harm. Some argue that it is wrong to get this vaccine so early on, it has a protection window span of five years, which is about the average age of the beginning of sexual activity for teenagers in the United States (CDC). Granted, not every teenager is the same or acts in the same ways, but if a young woman wants to become sexually active later on in life, and has not gotten the vaccine, they are putting themselves at risk for catching the vaccine if the partner who she has decided to have sex has had sex in the past with another partner who had… [read more]

H Pylori the Cause of Peptic Ulcers Research Paper

… Pylori the Cause of Peptic Ulcers

Helicobacter Pylori (H. Pylori) is known to be a bacteria found in the inner lining of the human stomach. Once in the stomach lining, it is known to produce a lot of chemicals into the human stomach that potentially damage the stomach lining. The infection is very difficult to eradicate and can persist for years over and even in some cases for life (Gastroenterological Society of Australia, 2006).

H. pylori causes inflammation of the persistent inflammation of the inner lining of the stomach (gastritis) hence counted as one of the top causes of ulcers in the world. It has been observed that the H. pylori is commonly spread or transmitted through contaminated food or water or through infected person to another person contact (Dennis Lee, 2011).

Dennis further estimates that 30% of all Americans are infected by the bacterium and among them, 50% are infected at the age of 60 years and above as Dennis Lee postulates. The infection is very common among the people living under crowded neighborhoods since it is easy to pass it from one person to the other as well as from one family to the next. Poor sanitation also exacerbates the situation with an estimated 90% of the adults living in the extremely poor sanitation conditions being prone to infection.

Once the person is infected, he carries the infection indefinitely unless he undergoes thorough treatment and medication to eradicate the bacterium from the body. It is estimated that one out of every six patients of the bacterium will suffer from ulcers of the duodenum or stomach. H. pylori is also associated with the stomach cancer and to some extent the rare kind of lymphocytic tumor of the stomach called MALT lymphoma.

Diagnosis of H. pylori

There are accurate and quite simple ways of diagnosing the presence of H. Pylori in the contemporary medical fields. These tests include urea breath test, endoscopic biopsies (gastroscopy), antibody test and stool antigen tests.

Antibody testing; this relies on the detection of lgG antibodies that are specific to the H. pylori bacterium. It is widely used because it is cheap and readily available. There are various testing mechanisms available like Western blot testing, immunochromatography, and enzyme-linked immunosorbent assay (ELISA). However, this test can only be used to detect the presence of H. pylori and not to confirm the effectiveness of the antibiotics administered since there can be persistent presence of the antibodies even after the H. pylori has been cleared (The BreathID System, 2011).

Endoscopy (gastroscopy); this is where the physicians take a clear look at the condition in the digestive tract and extracting samples of the stomach or…… [read more]

Role of Antibiotic Therapy Essay

… " (Lopez, et al., 2006) Subgingival plaque samples were also reported to have been taken from all teeth at baseline 3, 6, 9 and 12 months for the counts of 40 subgingival species using checkerboard DNA -- DNA hybridization." (Lopez,… [read more]

Care for Patients During Poor Air Quality Essay

… Asthma Patient Care on Poor Air Quality Days

Poor air quality is caused by a combination of ground level ozone and air pollution can worsen asthma symptoms, triggering wheezing, coughing, trouble breathing, and even lead to hospitalization in the most serious cases.

The most important factor for a nurse to be effective with the patient on a poor air quality day is the daily Asthma Care Plan. This should provide the patient with specific recommendations for how and when to use relief medications, list the warning signs of severe attacks, and provide guidance when a patient should seek medical care.

Special considerations for patients with asthma and other respiratory conditions should be instructed to stay indoors and follow these steps to optimize their breathing:

Stay indoors as much as possible.

Run the air conditioner.

If patients need to venture out, limit the time outdoors. It is very important to restrict strenuous activities to pre- and post- traffic hours, of early morning and later evening, when air quality improves. They can plan activities over the next few days by checking air quality forecasts from AIRNow, a website developed to monitor air quality across the country. Patients can arrange their schedules for major activities, such as grocery shopping for the cooler, safer hours of early morning and after sundown.

2) Keep medications on hand.

Now is the time to take preventative asthma medications, such as Advair or Flovent as prescribed, and have patients keep their rescue inhaler handy in case of an asthma attack. Also, be careful to check the expiration date of the inhaler to ensure that it is effective. Renew prescriptions as needed.

Precautionary note: If the patient is using their inhaler more than twice a week, this may be indicative that they need a preventative medication, or if currently taking one, that the dosage needs to be changed. Discuss this with a doctor.

The doctor's visit is also the time to discuss and outline the patient's Asthma-Action Plan. This would show them how to handle worsening asthma symptoms, and keep them prepared and ready for most circumstances.

Poor air quality days may be the cause of stepping up the patient's Asthma-Action Plan to a higher level, and thus being prepared for these more challenging days.

Considerations for Special Populations


Older children should have a written Asthma Plan for school, with activity restricted to indoors…… [read more]

Community-Based Intervention Public Health Planning Case Study

… Study Limitations

The primary limitation the authors cited was their reliance solely on the Citywide Immunization Registry, which likely consists of records that haven't been kept up-to-date by pediatricians (Findley et al., 2008). The prevalence of out-of-date records could be as high as 85%. The authors suggested that examining parent-held vaccination records would have provided a more accurate assessment, but the cost of such an approach was probably prohibitive.

Whether the same or similar program could be implemented nationwide would depend a great deal on each community's willingness to commit resources to a more intense program of reminding, tracking, and community outreach activities. Northern Manhattan could represent an exceptional neighborhood when compared to other urban communities of color across the country, in terms of having in place a vibrant social infrastructure consisting of social and housing services, faith-based organizations, childcare and primary providers, and city health department. Three factors therefore seem to be the primary determinants of whether such a program could be implemented successfully in the general population: the will to do so, resources, and a robust social infrastructure.

An alternative Research Strategy Proposals

The first study the authors conducted used a prospective cohort design (Findley et al., 2004) and the second used a retrospective cohort design (Findley et al., 2008). A potentially more powerful experimental strategy would be to randomize the neighborhoods or communities selected for participation in the Start Right program. For example, neighborhoods or school districts could be matched in terms of ethnicity, income level, Medicaid coverage, and provider density (Fu, Cowan, McLaren, Engstrom, and Teach, 2009), and then selected at random for participation in the Start Right program. The impact of community-wide trends in childhood vaccination rates would be averaged out over multiple neighborhoods or school districts. If necessary, multiple cities could be enrolled to increase the statistical power of the experiment.


Findley, Salley E., Irigoyen, Matilde, Sanchez, Martha, Guzman, Letty, Mejia, Miriam, Sajous, Michelle et al. (2004). Community empowerment to reduce childhood immunization disparities in New York City. Ethnicity and Disease, 14, S1-134 -- S1-141.

Findley, Sally E., Irigoyen, Matilde, Sanchez, Martha, Stockwell, Melissa S., Mejia, Miriam, Guzman, Letty et al. (2008). Effectiveness of a community coalition for improving child vaccination rates in New York City. American Journal of Public Health, 98(11), 1959-1962.

Findley, Salley E., Sanchez, Martha, Mejia, Miriam, Ferreira, Richard, Pena, Oscar, Matos, Sergio et al. (2009). REACH 2010: New York City: Effective strategies for integrating immunization promotion into community programs. Health Promotion Practice, 10(2), 128S-137S.

Fu, Linda Y., Cowan, Nuala, McLaren, Rosie, Engstrom, Ryan, and Teach, Stephen J. (2009). Spatial accessibility to providers and vaccination compliance among children with Medicaid. Pediatrics, 124,…… [read more]

Macroeconomic Case Study

… Macro Economic Case Study


It has been brought to our attention that there have been a number of shortages taking place (over the last ten years) for the flu vaccine. At the heart of this issue, is the overall quality of supply on the market. What has been happening is there were two different situations in 2001 and 2005 that were occurring. These illustrated how vulnerable stock piles were to these issues. This is because, the total number of regulations made it difficult to open a drug manufacturing plant in the United States. At the same time, the amounts of high risk people have increased dramatically. As there are currently 90 million Americans who require these vaccinations, due to the fact they could have a weak immune system or suffer from a chronic condition (such as: cancer, diabetes and hypertension). This is important, because it is showing how demand for these vaccines has increased, while the total amount of supply (that is manufactured in the United States) has decreased. ("Flu Vaccine Case Study")

As a result, over the last several decades the total number of suppliers providing vaccines has declined dramatically. Evidence of this can be seen by looking at: the total number of drug manufacturers with facilities, located in the U.S. over the last 35 years. as, this number declined from: a total of 25 to 5, which is making the underlying situation even worse. This is having a dramatic impact upon the quality of available supplies, with many manufacturing companies using foreign-based laboratories to create these vaccines. At which point, a shift took place in the market place, as demand increased and manufacturing was essentially outsourced. This lead to calls from economists and industry experts; that this exposing the available supply to: disruptions from a limited number of producers. Commenting about what was taking place former Health and Human Services Secretary Tommy Thompson said, "The flu vaccine marketplace has been withering away for years." This significant, because it shows how the underlying problem has been continuing…… [read more]

Ethical Issues Associated With This Marketing Strategy? Case Study

… ¶ … ethical issues associated with this marketing strategy?

Physicians have an ethical obligation to prescribe the most suitable treatment for a patient, based upon their medical knowledge, not upon persuasive techniques used by salespersons. For many years, the pharmaceutical industry has been dogged with charges that it uses 'freebies' like dinners, stationary, and food to persuade physicians that a name-brand drug is superior to others on the market. "The doctor is not going to prescribe something he or she has never heard of, and it's the drug representative's job to get the products' names in front of the physicians" not to improve patient health (Morreim 2011).

There are serious ethical implications regarding this charge. For example, if physicians are persuaded, even subliminally, to overprescribe, then there may be a rise in antibiotic-resistant bacteria, due to overuse of antibiotics. Children might be prescribed medication to treat ADHD and bipolar disorder as a means of first rather than last resort. Physicians may be more apt to bow to pressure from patients who ask for a specific drug, simply because the patient saw the pharmaceutical advertized on television and the doctor was the target of an in-house advertising campaign.

Overly aggressive physician targeting may thus encourage over-prescription, or may cause physicians to prescribe drugs rather than making consumers aware of generics, which are cheaper than name brand drugs. In this specific instance, training physicians to market the drug is designed to create an image of objectivity and trust, without fully informing the listeners that the physicians are disseminating sponsored materials. Even if there is a disclaimer, a small disclaimer will not necessarily fully convey the extent to which what the audience is seeing is 'advertising' rather than information.

"A recent letter in the Journal of the American Medical Association illustrates how effective drug advertising can be. It describes a patient who came into the hospital with an infected insect bite. The intern who first saw the patient first sensibly wanted to prescribe a nice, inexpensive penicillin…the resident overruled the intern and…decided the…… [read more]

Drug Database Article Review

… ¶ … National prescription drug database slowly becoming reality

Journal: Government Technology

Online at: http://www.govtech.com/e-government/National-Prescription-Drug-Database-Slowly-Becoming.html

One problem for law enforcement is the lack of a consistent medical and legal bookkeeping strategy for individuals being prescribed addictive prescription painkillers. Prescription drug addicts will often go from doctor to doctor, crossing state lines to get their 'fix' and often succeed in persuading unsuspecting doctors to give them more opiates. The 2005 National All Schedules Prescription Electronic Reporting allocated $50 million to states to create a program that will allow doctors interstate access to patient records, to make sure that the patient is not 'doctor swapping.' Although the program is still under-funded, and many states, including Vermont, are not actively participating in the program, it is hoped it will cut down on the number of patients using doctors to provide them with their 'fix.'

Author's Points: A coherent system across all 50 states is required for doctors to have the security of knowing that they have a full and complete picture of…… [read more]

Five Forces and Pharmaceutical Companies Case Study

… Rivalry causes companies to seek a competitive advantage over their rivals, to ensure profitability.

Barriers to entry are when existing companies protect their high profitability by inhibiting additional rivals from entering the market. Some companies may see rivals or competition as a major problem, a way to lower profitability. Companies may intentionally lower their prices to keep competition out; once the treat is no longer there they may then raise the price.

People are concerned about the pressure pharmaceuticals companies put on PBM, when then pressure doctors. The PMB pressure the doctors to write prescriptions that are lower in cost. The drug companies cannot pressure the doctors directly, since it is against the law to put that type of pressure on doctors. Pharmaceutical companies are not allowed to give doctors expensive gifts or do anything that may seem like a bribe. These are guidelines to protect the rights of patients (Higgins, 2006). Medication affects the health and wellness of individuals and their medical decisions should not be influenced by pharmaceutical companies. The forces in the industry place a lot of pressure on the pharmaceutical industry that then move that pressure to doctors and PBM. Doctors should have the freedom to write the prescription based on the patients needs. Many PBM offer discounts for buying generic drugs and some PBM may not pay for brand name drugs. This puts pressure on the doctors to write certain prescriptions and abstain from others. Patients should feel as though their doctor have their best interest in mind when treating them.


Higgins, M. (2006). Stricter gift ethics urged for doctors; study sees influence on diagnosis. The Washington Times.

Porter, M.E. (2010). Strategic management. Retrieved from http://www.quickmba.com/strategy/porter.shtml… [read more]

Excessive Use of Antibiotics Essay

… Excessive Use of Antibiotics

Alexander Fleming was the one to discover penicillin in 1929. He discovers the substance in 1940, with the help of other specialists, thus making one of the most important discoveries in the history of human kind. Selman Waksman coined the term "antibiotic." He used it in 1942 to name every each of the substances that are formed by a microorganism which is antagonistic to the development of other microorganism in high intensity. The definition that Selman Waksman used did not relate to the substances that are not formed by microorganism but kill the bacteria (gastric juices and hydrogen peroxide). Also the text did not include anything about synthetic antibacterial compounds (sulfonamides).

Now days, most of the antibiotics are semi-synthetic modifications of different natural compounds. For example the beta-lactam antibacterials include the carbapenems, the cephalosporins and the penicillins, which is a substance produced by fungi. Aminoglycosides are substances that are detached from living organism. They are also antibacterials that are synthetic products, the sulfonamides and the guinolones, for example. Antibacterials are divided in two groups: bactericidal agents and bacteriostatic agents. The first ones are killing bacteria, while the second are only slowing down bacteria growth.

Antibiotics are not only killing the "bad" bacteria but the ones that are benefic too. The most important benefic bacteria for human body are lactobacillus acidophilus and bifidobacterium bifidus. These bacteria help the human body in fighting against "bad" bacteria. Destroying this organism can make the human body less immune to bacteria, fungi, parasites and viruses. An excessive use of antibiotics destroys these benefic organisms, and, in this manner, leads to the yeast infection and other infections that can be even more harmful to the body. In the same time, antibiotics affect nutrients, such as vitamin a and C, which are needed in the fight against infections. Diarrhea is the one common effect of excessive use of antibiotics. This effect causes an important loss of nutrients, such as magnesium and zinc. Another effect of excessive use of antibiotics is the fact that the individual develops resistance to the substance. The bacteria become immune to the drugs, and create a new generation of bacteria, one that is stronger than the first. In this line of ideas, there are some infectious diseases that are unaffected by drugs. So, consequently, the excessive use of antibiotics is not helping the disease disappear, decreases immunity and makes diseases stronger, given that bacteria are not killed by the treatment.

Also, it is important that before the administration of the antibiotic one makes sure that there are no alternatives available. The U.S. Centers for Disease Control and Prevention (CDC) says that more than 10 millions antibiotics are prescribed for viral diseases that can be treated with an easier treatment.

Farmers and ranchers use antibiotics in an excessive way too. They use antibiotics not…… [read more]

Medical Research Funding - Government Business Proposal

… Much of the funding provided for the HGP served the development of new technologies, rather than the sequencing of the human genome itself. In addition, Celera started much later than the HGP and could take advantage of the experience gained by the HGP, which, as a publicly-funded project, made much of its work available as a basis upon which Celera could build.

While religious groups are readily providing funding for medical studies, they often place tight restrictions on study design, based on their views. On the other hand, depending on the medical condition being researched and the degree to which a cure could benefit the members of a church congregation, religious organizations may be a viable funding source.

HHMI Personnel and Qualification Summary

The Howard Hughes Medical Institute (HHMI) is best suited for this project. We are one the leading nonprofits for medical research. The organizational structure would include: the Board of Trustees, various advisory boards, and officers. Duties for officers include: managing funding, collaboration, monitoring the Janelia Farm Research Campus, and operations of the foundation.

These different elements are important, because they allow each project staffer to focus on specific activities.

The various members of HHMI that are filling key staff positions include: Robert Tjian (President), Craig Alexander (Vice President / General Council), and Sean Carroll (Vice President for Science Education). Robert Tjian has formal training as a biochemist and has been the President of HHMI since 2009. He received a Bachelor Degree from Berkeley and a PHD from Harvard University. The greatest contribution that Tjian has made to medical research is through his groundbreaking work, regarding how genes are turned on and off. Craig Alexander has acted as legal counsel for HHMI since 1994 and has been the Vice President since 2006. He has a Law Degree from the Georgetown University Law Center. Sean Carroll is in charge of Science Education for HHMI. He has been working as an HHMI investigator at the University of Wisconsin Madison, where he is a world famous biologist.

Partnerships and cooperating agencies include: 18 Nobel Prize winners, the National Academy of Sciences, and 335 HHMI investigators around the world. The various board members include: James Baker, Garnett Keith, Fred Lummis and Paul Nurse. All of the different individuals made annual contributions…… [read more]

Drug Companies and Poor Nations Term Paper

… Drug Companies and Poor Nations

The idea of easing international patent laws for medical drugs has polarized the political and business community for sometime. It is clear that the World Trade Organization (WTO) is a central hub for this discussion, the key points are: keeping the drug supply up to standards and safe; allowing pharmaceutical countries a way to recoup their R&D costs; provide greater services to LDC (lesser developed countries). It is also clear that many drug companies now see poorer nations as emerging markets for their products, particularly in areas in which there are fewer regulatory issues.

The safety and requirements of pharmaceuticals is paramount: there must be an organization that monitors and ensures that the required chemicals and percentages are used. One of the U.S. FDAs most stringent comments about the use of foreign pharmaceuticals is that they have to set standard of ingredients and, in many cases, might do more harm than good. Similarly, it is important to all countries that pharmaceutical organizations continue to research and develop new substances, if they are prevented from that, and their rights to intellectual property, they will no longer have any impetus to fund research (e.g. It can cost millions of dollars to get even one new drug approved, and estimates range from 80-90% of those that are put on trial never make it to production). Other countries do not have such standards, saving pharmaceuticals millions of dollars in costs, as well as the threat of litigation that looms in the developed world.

In the current world of globalization, though, the prevailing economic thought it that individual countries will produce and export their best resources, while importing, or manufacturing, needed items. A large country like India, for instance, with a large amount of human capital and investment opportunities, could indeed form a new pharmaceutical industry, if not research and development, at least production. This could, of course, happen in two ways: 1) International companies could open manufacturing plants in India. It has 30 major ports for importing of supplies, a…… [read more]

Translating Biomedical Innovation / Mental Term Paper

… With the ethical compliance requirements not so transparent in the private sector and their primarily commercial interest in biomedical research leads to several problems. In a collaborative setting, conflicts of interest arise out of such a situation. For instance, as… [read more]

Biology Vaccines Term Paper

… Biology


Almost everyone across the country gets vaccines. People often want to understand what vaccines are prepared out of, if they are effective, and whether they are harmless or not. They also want to understand why there are numerous vaccines and whether they are all actually needed. More often than not, they really want to understand what they are really receiving when they obtain a vaccine (Offit and Bell, 2003).

In recent years, new vaccines have become accessible; some vaccines have been replaced with others and some have been withdrawn. Parents have had doubts in regards to the security of an additive that was being used in a lot of vaccines and a number of writings have maintained that may result in sudden infant death syndrome, persistent joint disease, aggressive behavior, autism, diabetes and multiple sclerosis (Offit and Bell, 2003). So, just what are these vaccines anyway?

A vaccine is any solution proposed to create resistance to an illness by invigorating the creation of antibodies. Vaccines include solutions of dead microorganisms, or offshoots of microorganisms. The frequent technique of giving vaccines is by inoculation, but several are administered by other ways. Vaccines are extensively and regularly given internationally founded on the ordinary standard that it is improved to keep people from getting sick than to care for them once they become sick. Distress, disability, and fatality are evaded. Vaccination prevented about two million casualties in 2002. Additionally, infection is decreased, tension on health systems is relieved, and funds are regularly accumulated that can be utilized for additional health services (Vaccines, 2010).

Initiating a little quantity of smallpox virus by breathing in by way of the nose or by administering a number of tiny pierces through the skin, called variolation, in order to generate opposition to the illness appears to have started in the tenth or eleventh century in Central Asia. This extended into Asia and Africa, by way of the nasal technique. At the time in Europe it consisted of skin pierces. Variolation was brought into England in 1721. In 1798, Edward Jenner, after studying the victory of variolation with cowpox in defensive against smallpox, started to perform vaccinations in opposition to smallpox. This was the initial organized attempt to manage an illness by way of vaccination. In 1885, Louis Pasteur invented the first inoculation to defend people in opposition to rabies. Toxoids in opposition to diphtheria and tetanus were initiated in the 1900's; the bacillus Calmette-Guerin inoculation, against tuberculosis, was initiated in 1927; the Salk polio inoculation in 1955; and inoculations in opposition to measles and mumps in the 1960's (Vaccines, 2010).

Vaccines, as with all things overlooked by the FDA, experience a meticulous evaluation of laboratory and clinical statistics to guarantee the security, effectiveness, wholesomeness and influence of these products. Vaccines accepted for selling are also mandated to go through further studies in order to advance assess the inoculation and often to deal with exact questions in regards to the inoculations safety, efficiency or likely side effects.… [read more]

Ethical Decision-Making in Dentistry Term Paper


Ozar and Sokol-Based Ethical Analysis

According to Ozar and Sokol, their ethical framework for analysis and resolution of ethical dilemmas in dentistry considers the following specific issues and ranks their relative importance in the same order: First, the life and general health of the patient; second, the oral health history of the patient; third, patient autonomy; fourth, preferred practice values of dentists; fifth, esthetic values; and sixth, resource efficiency. There is no question that the Ozar-Sokol analysis requires the dentist to oppose the general practitioner's orders.

First, it is well-known that various acute and systemic infections, such as those capable of being caused by streptococci and staphylococcus bacteria are on a dramatic rise in the United States, particularly in connection with antibiotic-resistant strains. Because clinical experience and empirical research have conclusively established that, despite complete protocol compliance, invasive dental work (and other surgery more generally) can provide opportunities for bacterial infection, it is good general practice to prescribe a broad-spectrum antibiotic before invasive procedures. Since there is no question that it is in every patient's best interest to avoid unnecessary post-surgical complications and infections, the first Ozar-Sokol issue requires prophylactic antibiotic treatment.

Second, the oral health history of this patient is largely irrelevant to this particular dilemma, at least where that history is devoid of prior infectious complications. In that case, the first Ozar-Sokol principle requires antibiotics. However, if the patient's oral health history included any previous infections, the second Ozar-Sokol principle would become directly relevant and absolutely require prophylactic antibiotic treatment.

Third, patient autonomy is not directly relevant to this dilemma, only because the matter concerns different clinical judgment by practitioners. However, patient autonomy could be incorporated into a possible…… [read more]

Position Statement in Occupational Therapy Reaction Paper

… Occupational Therapy Position Statement

The current academic and professional climate is such that there are increasing demands not only for professional research and quality service, but also for the empirical basis of such research and service. Hence, empirical trials have become increasingly important in all fields of study. Occupational therapy is included in this phenomenon. The profession focuses on health and social care for individuals in need of this. The market is therefore increasingly demanding a high level of quality from professionals in the field, while also increasingly demanding that the service delivered by based upon empirical research. For this reason, one might surmise that the importance of clinical trials in the field is rising, and that this is vital not only for improving the quality of care provided, but also for targeted health care reform where this is most needed.

According to Unsworth (2000, p. 148), clients, insurers and employers have been particularly adamant regarding the quality and empirical nature of care received from occupational therapists. That such care must be evidence-based is coupled with the requirement that it be provided at the lowest possible cost. One of the best ways in which to achieve such a combination of quality and cost-effectiveness is by means of empirical evidence as obtained by means of clinical trials.

Authors such as Sperling (2009) also emphasize the importance of clinical trials in terms of the effect upon the ability of the medical profession to solve the problems it faces. In general, new treatments and drugs can only be approved when their efficacy are proved by means of clinical trials. In other words, such research validates the profession and its tools.

Although occupational therapy has not traditionally been regarded as subject to clinical trials, these have become increasingly important in the light of validation for the profession. As Unsworth (2000, p. 156), occupational therapy will only be transported to the 21st century by means of measurable outcomes achieved via clinical trials. In the profession itself, it is therefore important to increase the number of clinical trials conducted. This will have various effects and advantages.…… [read more]

What Can We Do About Antibiotic Resistant Bacteria? Lab Report

… ¶ … Lab Report Template (Save as: YourName_Module#_Report.doc)

Antibiotics were once called 'wonder drugs' because of their ability to fight some of the most serious diseases plaguing humankind. However, just as other species have changed through natural selection, bacteria that are resistant to antibiotics have survived and reproduced in greater number than less resistant strains. Slower development of new antibiotics and a spike in antibiotic prescriptions has precipitated the evolution of hardier and more virulent strains of antibiotic-resistant bacteria.

According to the Centers for Disease Control (2005) antibiotic-resistant bacteria develop when mutant strains of resistant bacteria survive a treatment, and "that one bacterium can then multiply and replace all the bacteria that were killed off. Exposure to antibiotics therefore provides selective pressure, which makes the surviving bacteria more likely to be resistant. In addition, bacteria that were at one time susceptible to an antibiotic can acquire resistance through mutation of their genetic material or by acquiring pieces of DNA that code for the resistance properties from other bacteria."

Antibiotic-resistant bacteria are dangerous because these "bacteria are able to cause serious disease and this is a major public health problem. Important examples are methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE) and multi-drug-resistant Mycobacterium tuberculosis (MDR-TB)," which have become epidemic in many healthcare environments when large numbers of ill people are in contact with one another ("Antibiotic-resistant bacteria," Better Health Channel. 2009). Unless proper precautions are taken, patients and healthcare providers alike can become unwitting transmitters of diseases.

Patients and doctors both share some of the blame for the development of antibiotic-resistant bacteria. Doctors may prescribe an antibiotic for what is likely to be a viral infection (which cannot be cure by an antibiotic) to placate a demanding patient, and patients may want to take an antibiotic, even when it is likely to be ineffective 'just in case' they might have a bacterial infection.

Materials and Methods:

The experiment was conducted on a 'macro' population level as well as a micro population level. To confirm that…… [read more]

Out of Trend Results Term Paper

… ¶ … Alasandro, Mark; James Bergam; Laura Faust, Marianne Gorko et al. (2003, April).

Identification of Out-of-Trend stability results: A review of the potential regulatory issue and various approaches. Pharmaceutical Technology.

Retrieved June 21, 2010 at http://pharmtech.findpharma.com/pharmtech/data/articlestandard//pharmtech/152003/52982/article.pdf

Out-of-trend results (OOT) are an important topic both for political and economic reasons in the pharmaceutical industry: they can affect how a drug is prescribed, administered, and regulated. Simply stated, an OOT is a statistical result about a drug that falls outside of expected parameters. A pharmaceutical company might attempt to establish an expiration date for a new medication, but an OOT result testing for drug efficacy can complicate setting such standards. Ideally, when reviewing statistical information, an alarm is sounded only when needed, and the risk of false alarms is minimized, while significant results are not overlooked.

When testing a batch, an anomalous result is usually flagged if three consecutive results are outside a preset limit or "the difference between consecutive results is outside of half the difference between the prior result and the specification" (Alasandro et al., 2003, p.42). Other red flags might be if results from the tests are greater or less than 5% of the initial result or the mean of all previous results or 3% of the previous result of the test.

A regression chart, a statistical by-time-point approach (to determine whether a result is within expectations in comparison with other batches measured at the same time), and a slope control chart method are all ways to examine the significance of deviations. Degradation of quality is of particular concern for pharmaceuticals, and "unlike batch-release results, which represent one point in time for a batch, stability results may change over the shelf life of the batch" (Alasandro et al.,, 2003, p.48). Thus while determining whether a batch is of a particular level of quality is vital, even more challenging…… [read more]

Medication Errors Term Paper

… Medication Errors in Nursing

Medication errors are a very serious concern to nursing staff. A medication error occurs when the wrong medication is given to a patient resulting in potential serious harm that could have been prevented (Hidle). Medication errors… [read more]

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