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Chronic Kidney Disease
Over the last several years, the issue of chronic kidney disease has been increasingly brought to the forefront. This is because when someone becomes older, the more likely they will develop this condition. According to the Center for Disease Control (CDC) and the National Kidney Foundation, once someone reaches above the age of 50, there is a 50% of them becoming susceptible to it. As they increase in age, these probabilities rise dramatically, with the most likely individuals having the greatest chances of experiencing chronic kidney disease at 70 years old. ("2014 National Kidney Disease Fact Sheet," 2014) ("Kidney Disease Facts," 2014)
However, in spite of these issues, the CDC determined that there are number of variables which increase the odds of someone developing the condition. They found that lifestyle choices are one of the biggest factors, with the disease steadily progressing in the course of time.…
, Sweet, Starkey, Shekelle, 2013, p. 835). Depending on whether the patient is in early-stage vs. late-stage prognosis, the patient will be offered different treatments and approaches to managing the disease and its effects.
According to Qaseem et al., Stage 1 -- 3 CKD is treated in a variety of methods; different types of medicine, diets, exercise, and other treatments and approaches are all available, some with better results than others of course. Additionally, the problems with screening for CKD are often harbingers of problems that will crop up as the disease progresses. The Qaseem et al. study determined that "expert opinion suggests that the harms of CKD screening include misclassification of patients owing to false-positive test results, adverse effects of unnecessary testing, psychological effects of being labeled with CKD, adverse events associated with pharmacologic treatment changes after CKD diagnosis, and possible ?nancial rami-cations of CKD diagnosis" (p. 837). In…
Baigent C, Landray MJ, Reith C, Emberson J, Wheeler DC, Tomson C, et al.; (2011) SHARP Investigators. The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomized placebo-controlled trial. Lancet. 2011;377:2181-92. [PMID: 21663949]
Chou, C.Y.; Liang, C.C.; Kuo, H.L.; Chang, C.T.; Liu, J.H.; Lin, H.H.; Wang, I.K.; Yang, Y.F. Huang, C.C.; (2014) Comparing risk of new onset Diabetes Mellitus in Chronic Kidney Disease patients receiving Peritoneal Dialysis and Hemodialysis using propensity score matching, PLoS, Vol. 9, Issue 2, pp. 1 -- 6
Qaseem, A.; Hopkins, Jr., R.H.; Sweet, D.E.; Starkey, M.; Shekelle, P.; (2013) Screening, monitoring, and treatment of Stage 1 to 3 Chronic Kidney Disease: A clinical practice guideline from the American College of Physicians, Annals of Internal Medicine, Vol. 59, Issue 12, pp. 835-848
Tonelli, M. & Wanner, C.; (2014) Lipid management in Chronic Kidney Disease: Synopsis of the kidney disease: Improving global outcomes 2013 clinical practice guideline, Annals of Internal Medicine, Vol. 160, Issue 3, pp. 182-189
Chronic Kidney Disease
CKD, or Chronic Kidney Disease, refers to the impairment a person suffers in his/her kidneys, which may result in their reduced function, as time progresses. Chronic Kidney Disease is used as a replacement for previously held terms, such as the Chronic enal Failure and Chronic enal Insufficiency by the paediatric nephrology specialists. These terms were formerly used to describe the reduction of renal functions, whether to a large extent or otherwise. However, the adoption of the name Chronic Kidney Disease came about because it described the progression of the organ's functional loss (Wong, Warady and Srivastava, 2015).
Chronic Kidney Disease can be detected through various symptoms, which are common to other diseases. However, they point to the disease in its formative stage. Some of these symptoms, which point to the onset of the disease are:
Constant tiredness and feeling ill
The loss of one's appetite
Arici, M. (2014). Clinical Assessment of a Patient with Chronic Kidney Disease. In Management of Chronic Kidney Disease (pp. 15-28). Springer Berlin Heidelberg.
Arora, P. (2015). Chronic Kidney Disease Clinical Presentation. Retrieved January 23, 2016, from http://emedicine.medscape.com/article/238798-clinical#b3
Coyne D. W. (2011). CKD Medscape CME Expert Column Series: Issue 3 -- Management of Chronic Kidney Disease Comorbidities. Retrieved 23 January 2016 from http://www.medscape.org/viewarticle/736181
Kathuria, P. (2015). Chronic Kidney Disease. Retrieved January 23, 2016, from http://www.emedicinehealth.com/chronic_kidney_disease/page9_em.htm
Baltimore Kidney Health
Chronic kidney disease (CKD) is a preventable problem. Yet as many as 26 million Americans already have CKD, and many more are at risk (National Kidney Foundation, 2012). Why do so many Americans have CKD if the problem is preventable? The answer is simple: lack of awareness. Americans at risk for CKD do not know that by simple changes to their diet and lifestyle habits, they can become healthier human beings. Moreover, their healthy habits will carry over into how their children and grandchildren live their lives. The purpose of this nutrition program is to highlight the simple changes that can be made to an individual's or family's diet. These changes cost little to nothing, and require only a commitment to health and positive change.
According to the National Kidney Foundation (2012), early detection can help the progression of kidney disease to kidney failure. Moreover, hypertension…
Lin, H.Y. (2012). Chronic kidney disease. PubMed Health. Retrieved online: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001503/
National Kidney Foundation (2012). Chronic kidney disease. Retrieved online: http://www.kidney.org/kidneydisease/ckd/index.cfm
Acute Kidney InjuryThe treatment of Acute Kidney Injury (AKI) has changed dramatically with the change in the management of comorbidities associated with it, such as hypertension. With this change, the rationale applied in the approach taken to treat these changes has also evolved. The use of pharmacologic treatment of AKI has been tried with varying success rates due to inefficiencies in implementing approaches used in trials with animals in humans or the effectiveness of some of the tries (1). Some of the experimental therapies used today are hypoperfusion, and the preventative intervention has been the intravenous administration of isotonic saline (3). The lack has informed intravascular volume expansion using isotonic saline of sufficient evidence that colloids are more effective for this purpose and evidence that some colloids may result in AKI. The high cost of colloids also limits their use.Action Mechanisms of the Drugs Used for TreatmentIn some patients, colloids…
1. Basile DP, Anderson MD, Sutton TA. Pathophysiology of acute kidney injury. Comprehensive Physiology (2012).
2. Chen TK, Parikh CR. Management of presumed acute kidney injury during hypertensive therapy: Stay calm and carry on? American Journal of Nephrology 51: 108–115, 2020.
3. Jo SK, Rosner MH, Okusa MD. Pharmacologic treatment of acute kidney injury: Why drugs haven’t worked and what is on the Horizon. Clinical Journal of the American Society of Nephrology 2: 356–365, 2007.
However, Harvard Medical School (HMS) reports that in that study of 1,400 patients, 222 "composite events occurred." Those "events" included 65 deaths, 101 "hospitalizations for congestive heart failure, 25 myocardial infarctions and 23 strokes."
In an understatement, the HMS report - written by Dr. Singh - concluded that while improving the lives of patients with CKD is "of paramount importance," this particular study reveals, "...Aiming for a complete correction of anemia is associated with increased risk, increased cost and no quality of life benefits." The study was published in the November 16, 2006 issue of the New England Journal of Medicine.
Meantime, the National Institutes of Health / Medline Plus (www.nim.nih.gov) explains that epoetin alfa is also used with people who have HIV, it is used prior to surgery and after surgery "to decrease the number of blood transfusions needed" in the predicable loss of blood during surgery. It is…
Harvard Medical School. (2005). Blood test can accurately diagnose heart failure in patients
With kidney dysfunction. Retrieved February 10, 2008, at http://www.hms.harvard.edu .
Harvard Medical School. (2006). Higher Doses of Anemia Drug for Chronic Kidney Disease
Does Not Improve Quality of Life and Increases Risk for Cardiovascular Events. Retrieved February 9, 2008, at
For example, in these procedures it is often difficult to open the patient's mouth wide enough for laryngoscopy and intubation, thus creating the possibility that cardiopulmonary changes may be present and the "probability o lesions in oesophagus, bowel, kindneys, skin and joints." This information would not be known if not for this study and its reported findings.
The study's conclusion is that the use of thoracic epidural anesthesia to sevoflurane based inhalation "may be a suitable technique for thoracic surgery in achalasia due to sclerodermic patients." The reason for this conclusion is that the study found that this procedure "can provide a smooth anesthesia course and a rapid recovery, with hemodynamic stability, and also having pain-free postoperatively." More so, the study found that providing anesthesia without neuromuscular blockade and non-intravenous opioids has "provided a shorter recovery time."
Clearly this specific case study has important and practical implications to the practice…
Erol, Demet Dogan, M.D. (2006): "Thoracic Epidural Blockade in an Elderly with Achalasia Due to Scleroderma for Thoractomy, Esophageal Myotomy and Cystotomy-Capitonnage. The Internet Journal of Anesthesiology. Vol. 11, Number 1.
Chronic Kidney Disease
Chronic kidney disease commonly develops alongside diabetes and/or high blood pressures. Patients who suffer from either are at risk of also developing chronic kidney disease. This is because high blood sugar can cause damage to the kidneys in the same way that a car exposed to wintery weather conditions is impacted by the salt that the city will dump on the road to control for ice. The car will be ruined if not properly cleaned and maintained—and the same goes for the body’s kidneys. To prevent chronic kidney disease the patient must first address the issues of diabetes and/or high blood pressure. Obesity is also a factor in the progression of kidney disease. Additionally, chronic kidney disease can lead to hypertension if this is not already a factor. The reality is that an individual who suffers from chronic kidney disease is likely to suffer from stress, poor…
(2012) conducted a cohort study in which a large (over three million) group of patients had their renal activity monitored. The study ultimately came to focus on the subgroup who had undergone kidney stones: these were followed up with and examined, at a median follow-up period of eleven years, in Alberta, Canada. The goal was to examine patients who had experienced at least one episode of kidney stones and to see if that correlated with any other forms of kidney disease (up to and including end stage renal disease) later in life. The basic measure used for examining the patients on the follow-up visit was the level of serum creatinine, the most basic measure of kidney health that is available to physicians. Those patients who had double the expected serum creatinine level were judged to have chronic kidney disease.
The most unexpected finding from the cohort study was the effect…
Alexander, RT, Hemmelgarn, BR, Wiebe, N, et al. (2012). Kidney stones and kidney function loss: A cohort study. British Medical Journal 2012 Aug 29-345:e5287. doi: 10.1136/bmj.e5287. PMID: 22936784
DuRant, E and Leslie, NS (2007). Polycystic ovary syndrome: A review of current knowledge. Journal of Nurse Practitioners 3(3):180-185.
Chronic Illness: Coronary Heart Disease
Outline of Coronary Heart Disease
The Coronary Heart Disease (CHD) has been on the increase of late across the globe and this disease, alongside stroke have been the top causes of death in many countries like Australia (Baker Heart and Diabetes Institute, 2017). There have been cases of people succumbing to complications occasioned by the CHD hence the need for any medic or clinician to fully furnish themselves with the CHD and the causes and effects as well as how it can be managed.
CHD is a disuse characterized by the development of a waxy substance called plaque building up in the inner walls of the coronary arteries. These are the arteries responsible for supplying oxygen-rich blood to the heart muscles. The buildup of plaque on the inner walls of the arteries results into atherosclerosis and this takes many years to pile up to harmful…
Baker Heart and Diabetes Institute, (2017). Heart disease and stroke are the top two causes of death -- and among the leading causes of disability -- in Australia. Retrieved April 9, 2017 from https://baker.edu.au/health-hub/fact-sheets/cardiovascular-disease?gclid=Cj0KEQjwt6fHBRDtm9O8xPPHq4gBEiQAdxotvNmN_YV05am6ts6wLgbbEPubE3I2Z6wwGSNl0AaycX0aAnFy8P8HAQ
Cleveland Clinic, (2017). Coronary Artery Disease Symptoms. Retrieved April 9, 2017 from https://my.clevelandclinic.org/health/articles/cad-symptoms
Mayo Clinic, (2017). Coronary Heart Disease: Symptoms and Causes. Retrieved April 9, 2017 from http://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/dxc-20165314
Southern Cross, (2017). Coronary heart disease - causes, symptoms, prevention. Retrieved April 9, 2017 from https://www.southerncross.co.nz/group/medical-library/coronary-heart-disease-causes-symptoms-prevention
Alcoholic Liver Disease
CAUSES AND IMPACT
Causes, Incidence, Risk Factors, Impact
Alcohol use has been linked with liver disease mortality and increased social and economic costs (NCI, 2014; ruha et al., 2009). Most recent statistics say that disorders in alcohol consumption afflict millions of people worldwide. The incidence has been increasing along with increasing alcohol consumption. Alcohol liver disease takes the form of acute alcoholic hepatitis and chronic liver disease, such as steatosis, steatohepatitis, fibrosis and cirrhosis. Seriousness and prognosis depend on the amount consumed, the pattern of drinking and the length of time of consumption, the presence of liver inflammation, diet and nutritional and genetic disposition. While steatosis is virtually benign, morbidity and mortality are both high in liver cirrhosis. Survival rate for advanced cirrhosis is 1 to 2 years and 50% mortality risk for those with severe acute alcoholic hepatitis have as much as 50% mortality (NCI, 2014).…
Bruha, R., et al. (2009). Alcoholic liver disease. Vol. 110 # 3m Prague Medical Report:
PubMed Central. Retrieved on April 6, 2014 from http://www.ncbi.nlm.nih.gov/pubmed/19655694
EASL (2012). EASL clinical practical guidelines: management of alcoholic liver disease. Vol. 51 # 1, Journal of Hepatology: European Association for the Study of the liver. Retrieved on April 6, 2014 from http://www.easl.eu/assets/application/files/5e1b5512fb2cabb_file.pdf
Frazier, T.H. (2011). Treatment of alcoholic liver disease. Vol. 4 # 1, Therapeutic
Diabetic Vascular Disease state caused by the deficiency of a chemical in the body called insulin which is a hormone is called Diabetes. There are two forms of diabetes. In the type-one diabetes no insulin is formed and people require insulin injections for existence. This was once thought it would affect only children, but now it can occur at any age. The type2 diabetes is due to the resistance of the body towards the effects of insulin. This also includes insulin which is insufficient. ut in this type there is some amount of insulin produced. In both the types the blood glucose levels is increased. When compared to people without diabetes, people with diabetes are prone to certain problems. These problems occur in the nerves (neuropathy), kidney (nephropathy) and eye (retinopathy). These people are prone to early heart attacks and stroked due to the hardening of the arteries (arteriosclerosis). With…
Diabetes Basics-About Diabetics," Retrieved from www.orthop.washington.edu/faculty/Hirsch/diabetesAccessed on March 3, 2004
Diabetes & Vascular Disease Research" retrieved from www.medstv.unimelb.edu.au/Research/DCVDR/. Accessed on March 3, 2004
Haptoglobin: A major susceptibility gene for diabetic vascular complications," retrieved from www.pulsus.com/europe/07_02/szaf_ed.htm. Accessed on March 3, 2004
Pathophysiology of Diabetes" retrieved at http://www.dhss.state.mo.us/diabetes/manual/DMOverview.pdf. Accessed on March 3, 2004
A way to better distribute the information that is being taught in the classrooms is also through the community so that the changes are also effecting the parents to the students, as a change on their part as well would be helpful in the battle against obesity. It would be useful to initially target pamphlets, an informational booth or table at grocery stores, where the foundation of the problem lies. It would be effective if information is given before families go grocery shopping so they are more conscious of the items that they are purchasing. Furthermore, information should also be initially presented on TVs, in newspapers and magazines and other mediums that would likely be used in the more low-key and sedentary setting in order to galvanize individuals to get outside. Once outside, in order to sustain the physical activity, it would be nice to have water and juice at…
Ahuja, Gitika, & Salahi, Lara. (11, February 2010). School nutrition program takes up obesity fight. Retrieved from http://abcnews.go.com/GMA/OnCall/school-nutrition-program-takes-obesity-fight/story?id=9802468
CausesofChildhoodObesity.org, Initials. (2010). Causes of childhood obesity. Retrieved from http://causesofchildhoodobesity.org/
Facts about obesity in the United States. (n.d.). Retrieved from http://www.cdc.gov/pdf/facts_about_obesity_in_the_united_states.pdf
Mayo Clinic Staff, Initials. (2011, May 06). Risk factors. Retrieved from http://www.mayoclinic.com/health/obesity/DS00314/DSECTION=risk-factors
Additionally, there may be patients that will be found to have the early symptoms of CKD, and those test results will be passed on to the individual patient.
All participants will be invited to learn more about CKD, and a one-night informational meeting will be conducted in which informational brochures will be passed out to the attendees, and will be discussed in detail. The attendees will also be provided the opportunity to give feedback (positive or negative) concerning their experiences with the early testing and how they view CKD from a current view as compared to their previous perceptions.
After all the data has been gathered and analyzed, a paper will be compiled that presents the results, along with a discussion of those results. It is hoped that the results will provide information to the medical community concerning how early testing and positive reinforcement can be effectively used during the…
Drabble, S.J.; O'Cathain, A.; Thomas, K.J.; Rudolph, A.; Hewison, J.; (2014) Describing qualitative research undertaken with randomized controlled trials in grant proposals: A documentary analysis, BMC Medical Research Methodology, Vol. 14, Issue 1, pp. 1 -- 17
Jansen, D.L.; Heijmans, M.; Rijken, M.; Spreeuwenberg, P.; Grootendorst, D.C.; Dekker, F.W.; Boeschoten, E.W.; Kaptein, A.A.; Groenewegen, P.P.; (2013) Illness perceptions and treatment perceptions of patients with chronic kidney disease: Different phases, different perceptions? British Journal of Health Psychology, Vol. 18, Issue 2, pp. 244 -- 262
Kokonvei, G.; Urban, R.; Reinhardt, M.; Jozan, A.; Demetrovics, Z.; (2014) The difficulties in emotion regulation scale: Factor structure in chronic pain patients, Journal of Clinical Psychology, Vol. 70, Issue 6, pp. 589-600
Lewis, R.; (2013) An overview of chronic kidney disease in older people, Nursing Older People, Vol. 25, Issue 10, pp. 31 -- 38
Studies conducted over decades have concluded that there is a significant link between diabetes mellitus and cardiovascular disease. For instance, the most common form of diabetes is type 2 diabetes, which involves both the impairment in insulin resistance and the defective secretion of insulin by the pancreas. The development of diabetes often comes with a number of cardiovascular complications including "coronary heart disease (CDC), stroke, peripheral arterial disease, nephropathy, retinopathy, and possibly neuropathy and cardiomyopathy." (Grundy 1999)
Specifically both diabetes type 1 and type 2 are considered to be risk factors for atherosclerotic coronary heart disease. "Moreover, myocardial ischemeal due to coronary atherosclerosis commonly occurs without symptoms in patients with diabetes." (Grundy 1999) In other words, patients with diabetes are more likely to be stricken with congestive heart failure. But it is not only the risk of heart failure that diabetes sufferers are at risk from, another…
"eGFR." Lab Tests Online, Available from http://labtestsonline.org/understanding/analytes/gfr/tab/test
"Glomerular Filtration Rate (GFR)" National Kidney Foundation Available from http://www.kidney.org/kidneydisease/ckd/knowgfr.cfm
Grundy, Scott. Et al 1999, "Diabetes and Heart Disease: A Statement for Healthcare
Professionals from the American Heart Association" AHA Scientific Statement.
Diabetes in Australia
The Australian government and the relevant Health agencies have for many years strived to put the diabetes menace under close observation and management. There have been massive researches and huge sums directed towards good management and possible elimination of diabetes at the national levels. This commitment is exhibited by the specialized funds and efforts like the Juvenile Diabetes esearch Fund (JDF) that has been committed to striving to mitigate the effects of diabetes from the render age of the Australians.
Since diabetes is such a big challenge to Australia as a whole, diabetes mellitus was declared a National Health Priority Area in 1996 during the Australian Health Minister's Conference and this was as recognition to the high levels of diabetes prevalence within Australia, the mortality rates that were due to it, the impact it had on morbidity and the possibility of the health improvements that can be…
American Diabetes Association, (2013). Kidney Disease (Nephropathy). Retrieved May 13, 2013 from http://www.diabetes.org/living-with-diabetes/complications/kidney-disease-nephropathy.html
Australian Government, Department of Health and Ageing, (2012). Diabetes. Retrieved May 13, 2013 from http://www.health.gov.au/internet/main/publishing.nsf/Content/pq-diabetes
Australian Institute of Health and Welfare, (2011). Diabetes Prevalence in Australia Detailed estimates for 2007 -- 08. Retrieved May 13, 2013 from http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737419307
Baker IDI, Heart & Diabetes Institute (2013). Diabetes: The Silent Pandemic and its Impact on Australia. Retrieved May 13, 2013 from http://www.diabetesaustralia.com.au/Documents/DA/What%27s%20New/12.03.14%20Diabetes%20management%20booklet%20FINAL.pdf
Renal failure, or commonly referred to as kidney failure, is a condition in which the kidneys do not sufficiently filter out the toxins and waste products that are transported in the body's blood stream. There are two basic forms of renal failure. The first is when there is an acute injury prevents the kidneys from functioning properly. The next is a more serious condition in which the kidneys are chronically inflicted. Chronic kidney disease has the potential to be irreversible and requires immediate medical attention. Some of the symptoms of renal failure include (Lin, 2011):
General ill feeling and fatigue
Itching (pruritus) and dry skin
eight loss without trying to lose weight
Other symptoms that may develop, especially when kidney function has gotten worse, include:
Abnormally dark or light skin
Brain and nervous system symptoms:
Drowsiness and confusion
Problems concentrating or thinking
Lin, H. (2011, September 21). Medline Plus. Retrieved from Chronic Kidney Disease: http://www.nlm.nih.gov/medlineplus/ency/article/000471.htm
MedlinePlus. (2011, September 21). Chronic Kidney Disease. Retrieved from MedlinePlus:
incidence of diabetic nephropathy, its etiology, its comorbidities, and how to control it. The best type of 'cure' is, as always, prevention, and close regulation of the disease which is particularly important since diabetic nephropathy can be fatal.
Diabetic nephropathy is the primary etiology of chronic kidney disease and kidney failure. Unfortunately, type 2 diabetes mellitus is skyrocketing in the United States alone to over 21 million cases, it is imperative for health care professionals to understand the mechanisms of diabetic nephropathy. This is particularly so since early recognition and prevention of the disease as well as tight serum glucose control can help prevent diabetic nephropathy from occurring thereby leading to potentially longer life for its carriers.
The authors describe the characteristics and etiology of diabetic nephropathy explaining how and why it can result in kidney disease and kidney failure.
Understanding these mechanisms can help us prevent kidney failure from…
My practice makes me in constant contact with patients who need to regulate their diabetes in order to prevent complications from occurring. Since patient compliance is irregular and challenging to achieve, and since the emotional and economic costs of diabetes -- as pointed out -- are huge -- it is my responsibility to attempt to help the patient as much as I can. Rather than feeling frustrated and helpless, the article shows me that I can do something: simply by being warm and caring. I can -- and do -- educate the patient on the complications of their disease. I can go beyond that in providing them with empathy, patience, and the time to listen to and refer them to available assistive agencies. In this wait, my practice extends far beyond the practical duties of nephrology. It lingers onto social work, counseling, and teacher. But, then again, these are the duties of the nurse who literally has to 'nurse' the patient back to health.
Sego, Sherril (2007) Pathophysiology of Diabetic Nephropathy Nephrology Nursing Journal, 34(6), 631 -- 633
Hypotension & Antihypertensives
Antihypertensives should not be withheld just for hypotensive purpose. Patients with other high risk conditions, such heart failure, IHD, chronic kidney disease, recurrent stroke, etc., should be given antihypertensives inspite of hypotension. Patients with hypertension target organ damage, or at risk of, should continue antihypertensives, even with hypotensive events. Pregnant women with chronic hypertension who are at risk of preeclampsia should also continue with antihypertensives, even with hypotension situations.
"Therapeutic decisions in individuals with hypertension and other high risk conditions, such as heart failure, IHD, chronic kidney disease, recurrent stroke, etc., should be directed at both the compelling condition and lowering blood pressure" (National High Blood Pressure Education Program, 2004, Aug). According to the authors, 40-50% of patients with heart failure symptoms have preserved systolic function and are more likely to have hypertension, LVH, and isolated diastolic dysfunction. Progression to more severe stages of left ventricular dysfunction…
Carson, M.P. (2014, May 6). Hypertension and Pregnancy. Retrieved from Medscape: http://emedicine.medscape.com/article/261435-overview
Program, H.B. (2004, Aug). Special Situations in Hypertension Management. Bethesda, MD Retrieved from
CKD - Design
Designing a study that evaluates an intervention must take several items into consideration in order to be determined as both reliable and valid; even if the study is in reality a health promotion goal, it is still necessary to treat it the same way a study would be treated. Determining what is reliable and what is valid therefore is an important step in both including those two objectives in a study, and achieving them as well. Study reliability is determined when the researcher can expect the same results time and time again by replicating research procedures. If a study is set up to determine results, and those results can be replicated, then the researcher can determine that the results are reliable. hen the researcher is attempting to show reliability, the researcher wants an independent observer to be capable of replicating results of the study using the same…
Jenkins, J.O.; (2010) A multi-faceted formative assessment approach: Better recognizing the learning needs of students, Assessment and Evaluation in Higher Education, Vol. 35, Issue 5, pp. 565 -- 576
Joughin, G.; (2010) The hidden curriculum revisited: A critical review of research into the influence of summative assessment on learning, Assessment and Evaluation in Higher Education, Vol. 35, Issue 3, pp. 335 -- 345
Schmitz, C.C.; Chipman, J.G.; Yoshida, K.; Vogel, R.I.; Sainfort, F.; Beilman, G.; Clinton, J.; Cooper, J.; Rejhsen, T.; Sweet, R.M.; (2014) Reliability and validity of a test designed to assess combat medic's readiness to perform life-saving procedures, Military Medicine, Vol. 179, Issue 1, pp. 42 -- 48
Critical Pathway: Chronic enal Failure
egents Online Degree Program
Critical Pathway: Chronic renal failure
Chronic renal failure is often occasioned by chronic kidney disease, immune disorder, trauma among other conditions. It does not have any specific symptoms and might include feeling unwell generally and experiencing a reduced appetite. It is diagnosed following screening of individuals who are identified to be at risk of kidney problems, like individuals with diabetes or high blood pressure and others who have blood relative with chronic kidney disease. It always seems complex when trying to come up with the right diagnosis for a patient.
M.A. is a 60-year-old man who has a stage V chronic kidney disease mainly as a result of diabetic nephropathy and a 12-year of type 2 diabetes. He has symptomatic peripheral vascular insufficiency, and 3 years ago he had undergone coronary artery bypass 3. Within the ten months that…
Ahern J, Kruger DF, Gatcomb P, Petit W, Tamborlane W.,(1989). The Diabetes Control and Complications Trial (DCCT): the trial coordinators perspective. Diabetes Educ 15:236 -- 281
Bassilios N, Launay-Vacher V, Khoury N, et al. (2001) Gabapentin neurotoxicity in a chronic haemodialysis patient. Nephrol Dial Transplant.
Blum RA, Comstock TJ, Sica DA, et al.(1994). Pharmacokinetics of gabapentin in subjects with various degrees of renal function. Clin Pharmacol Ther;56(2):154-159
Brawek B, Loffler M, Dooley DJ, Weyerbrock A, Feuerstein TJ.(2008) Differential modulation of K (+)-evoked (3)H-neurotransmitter release from human neocortex by gabapentin and pregabalin. Naunyn Schmiedebergs Arch Pharmacol.:376(5):301-307
educing obesity is seen as the primary goal of these efforts, but part of combating obesity is engaging in more active lifestyles and thus the educational efforts Oklahoma is planning will address both identified risk factors for diabetes. Strategies outlined that will assist in achieving the objective of reduced obesity other than through an increase in the availability and effectiveness of education include working for better policy development and implementation that directly encourages more healthy choices and behaviors, a better integration of various local programs and resources available throughout the state, and ensuring that evidence-based practices are used in medicine.
The State of the State report notes that infant mortality is higher in Oklahoma than in the rest of the country, with a lack of adequate prenatal care being a contributing factor in this issue. Healthy People 2020 addresses this issue in calling for a greater awareness of infant…
Healthy People 2020. (2011). Accessed 8 October 2011. http://www.healthypeople.gov/2020/default.aspx
Oklahoma State of State Report. (2011). Accessed 8 October 2011.
These clinics will have to be set up over a number of years as funding becomes available for each. It is envisioned that the combination of clinics and learning programs will help the community to achieve better overall health. Indeed, clinics that focus on the specific health issues faced by the Hispanic community will remove some of the burden from general-purpose clinics and hospitals.
In conclusion, it is projected that the above-outlined prevention strategies can go a long way towards significant improvements in the health of the Hispanic community. In addition to addressing specific renal failure problems, prevention measures and better access to clinics can also result in a better overall health and lifestyle experience for the Hispanic community. It is therefore proposed that these measures be implemented and thoroughly researched for both short- and long-term effectiveness.
Bibby, M. (2009). Advocacy strategies for government sponsored public health agencies:…
Bibby, M. (2009). Advocacy strategies for government sponsored public health agencies: The BCCDC a case study. Simon Frasier University. Retrieved from:
DaVita Healthcare (2014). Risks for CKD in Hispanic-Americans. Retrieved from:
http://www.davita.com/education/article.cfm?educationMainFolder=causes-of-kidney-disease&category=assessing-your-risk&articleTitle=risks-for-ckd-in -- hispanic-americans&articleID=5009
Leading and Managing a Change in Clinical Practice: Patient on Ventilator and the Usage of Saline in Performing Suctioning
Organizational direction depends on many factors. Most of them were an integral part of clinical practice for a while, but until the latter part of the 20th century has been so prominent in the organizational structure. This paper will explore the four factors that influence the management of clinic and are characterized by efficient designs. This paper will discuss about the leadership and management in relation to improving quality, change, care management, values and results. We will also present integration and possible implementation concepts, tools and strategies.
Suctioning the patient on ventilator pose a unique challenge in following a clinical pathway or case management model of care. Our patient is on ventilator and we are performing suctioning by the usage of saline solution. Multiple decisions need to be made when…
Dougherty, Lisa and Lister, Sara (2004) The Royal Marsden Hospital Manual of Clinical Nursing Procedures Sixth Edition (Royal Marsden Nhs Trust) Wiley-Blackwell; 6th Edition (24 Jun 2004) 896 pages
Hamric, A.B. (with Spross, J.A, Hanson, C.M.), Spross, J.A.(with Hanson, C.M.), & Hanson, C.M. (2005). Advanced practice nursing an integrative approach (Third, pp. 311-335)
Kelly, Diane. (2007) Applying quality management in healthcare: A systems approach. 2nd Edition: Health Administration Press. P. 17-89
Kovner, A.R., Neuhauser, D., (ed). (2004). Health Services Management; Readings, Cases, and Commentary (eighth, pp 125-271). Chicago, IL: Health Administration Press. Washington, D.C.: AUPHA Press
Alcohol on Urine Formation
The functioning of cells in the body depends on the supply of the required nutrients and the elimination of waste in the body. The extracellular fluid that surrounds different cells also thrives in stable chemical and physical conditions. While water is one of the most vital substances that provide such an environment; the concentration of hydrogen ions in the body influences the permeability, cell structure and rate of metabolic reactions (Epstein, 1997). In the human body, the kidneys are responsible for regulating different amounts and concentration of all these substances. They ensure that the large variation in the intake or loss of different substances does not interfere with the normal functioning of the body.
The consumption of alcohol has been proven to have adverse effects on the process of urine formation. According to Dasgupta (2011), this may occur directly because it affects the functioning of the…
Dasgupta, A. (2011). The Science of Drinking: How Alcohol Affects Your Body and Mind. Maryland: Rowman and Littlefield Publishing Group, Inc.
Epstaein, M. (1997). Alcohol's Impact on Kidney Function. Alcohol Health and Research World. Retrieved 21 April from http://pubs.niaaa.nih.gov/publications/arh21-1/84.pdf
ecause this is true, it is critically clear that the nursing leadership manager's role is one of a vital nature and that support for nurses in their role is the primary component that must necessarily be integral to leadership in nursing in dialysis units if the turnover of nurses is reduced to the lowest possible level. The nursing leadership manager's role is one that must proactively deal with burnout of these dialysis unit nurses instead of attempting to address these as they occur. Prevention is 'key' toward this end. As the demands grow for quality and competent nursing staff so does the need grow for competency in leadership nursing manager roles. ecause the dialysis unit nurse is very closely involved in their patient's care and because these patients are required to report for treatment several days a week for several hours a day the nurse's mental, physical and emotional state…
Aiken, L.H., & Patrician, P. (2000). Measuring organizational traits of hospitals: The Revised Nursing Work Index. Nursing Research, 49, 146-153.
Aiken, L.H., & Sloane, D.M. (1997). Effects of organization innovation in AIDS care on burnout among urban hospital nurses. Work Occupation, 42, 453-477.
Aiken, L.H., Clarke, S.P., Sloane, D.M., Sochalski, J., & Silber, J.H. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction [Electronic version]. JAMA, 288, 1987-1993.
Aiken, L.H., Clarke, S.P., Sloane, D.M., Sochalski, J.A., Busse, R.A., Clarke, H., Giovanetti, P., Hunt, J., Rafferty, a.M., & Shamian, J. (2001). Nurses' reports on hospital care in five countries [Electronic version]. Health Affairs, 20, 43-53.
New Graduate Position Selection Criteria
Demonstrated High Level Interpersonal, Verbal And Written Communication Skills
When I worked at the eader's Bookstore, I nurtured skills and applied them in the areas mentioned above. I dealt with customers regularly, and staff and suppliers over the phone and in person. I was charged with handling customer enquiries. I applied my communication skills to the fullest extent. Dealing with book request orders involved contacting the supplier on phone, updating the computer system with the data of the customer and the book/s ordered, making the book order and reaching back to the customer to alert them when the order has been delivered. I also captured the same information in the bookstore's filing system for use by others in the firm. I established a good relationship with customers and suppliers through effective communication strategies. I also rendered effective customer service. My line manager gave a positive…
American Association of Colleges of Nursing -- Interdisciplinary Education and Practice. (2016). Aacn.nche.edu. Retrieved 8 March 2016, from http://www.aacn.nche.edu/publications/position/interdisciplinary-education-and-practice
Brent, N. (2016). WHAT IS RISK Management AND HOW DOES IT HELP ME? Cphins.com. Retrieved 8 March 2016, from http://www.cphins.com/blog/post/what-is-risk-management-and-how-does-it-help-me
Browne, C. (2016). Job Description for a Registered Nurse in an Acute Care Hospital. Work.chron.com. Retrieved 8 March 2016, from http://work.chron.com/job-description-registered-nurse-acute-care-hospital-21331.html
Career FAQs Team. (2016). Selection criteria sample: Ability to apply academic knowledge and concepts to practical situations. Career FAQs. Retrieved 8 March 2016, from http://www.careerfaqs.com.au/careers/resumes-and-cover-letters-tips/selection-criteria-sample-ability-to-apply-academic-knowledge-and-concepts-to-practical-situations
When evaluating completions rates involved with PWA, radial tonometry had a 66% and carotid tonometry had a 99%. The radial tonometry was determined to be easier on the patient.
Laser Doppler Imaging (LDI)
Laser Doppler Imaging (LDI) has increased significance over previous single probe techniques. lood flow is no longer measured at a single site but between an area and the LDI due to being non-contact cannot interfere with the final results. LDI is a 1mm laser beam that uses a mirror to scan in two dimensions. A small amount of light penetrates the skin; the depth depends on wavelength and absorption, of area scanned and interacts with cells and tissues. Speed and density of moving cells determine the signal sent to detector. Discovery Technology International defines the amount of tissue measured as:
we have estimated that for well-perfused tissue such as muscle, the mean sampling depth for our probes…
Arnett, D. (n.d.). Arterial Stiffness and Hypertension. Retrieved on April 12, 2010 from http://www.fac.org.ar/scvc/llave/hbp/arnett/arnetti.htm
Bailey, B.; Jacobsen, D.; LeCheminant, J.; Kirk, E.; & Donnelly, J. (2003). The Effect of Analysis Method in Determining Change in Post Exercise Oxygen Consumption.
Retrieved on April 12, 2010 from http://journals.lww.com/acsm-msse/Fulltext/2003/05001/The_Effect_of_Analysis_Method_in_Determining.1004.aspx
Balmain, S., Padmanabhan, N., Ferrel, W., Morton, J. & McMurray, J. (2007). Differences in arterial compliance, microvascular function and venous capacitance between patients with heart failure and either preserved or reduced left ventricular systolic function. Retrieved on April 12, 2010 from http://eurjhf.oxfordjournals.org/content/9/9/865.full
Morbidity and Mortality Statistics:
Hypertension affects around 1 in 3 Americans and according to the CDC only 52% of people have this condition under control (CDC.gov, 2016). In older men, two-thirds have hypertension, and one-third of white men have hypertension. There are nearly 1000 deaths from hypertension daily in the United States, around 360,000 per year. Hypertension is related to first heart attacks, strokes and chronic heart failure.
The patient also suffers from orthostatic hypotension, which is when blood pressure drops when going from a lying or sitting position to standing. The largest risk for elderly people is the increased risk of falling that this brings. The patient may have fallen because of this condition. It is caused by, or linked to, high blood pressure and prolonged bed rest, as well as other conditions not faced by this patient. Anemia or vitamin B12 deficiency is another potential contributor…
CDC.gov (2015). Postural hypotension. CDC.gov. Retrieved May 14, 2016 from http://www.cdc.gov/steadi/pdf/postural_hypotension-a.pdf
CDC.gov (2016). Atrial fibrillation fact sheet. CDC.gov. Retrieved May 14, 2016 from http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_atrial_fibrillation.htm
CDC.gov (2016) Heart disease facts. CDC.gov. Retrieved May 14, 2016 from http://www.cdc.gov/heartdisease/facts.htm
CDC.gov (2016). High blood pressure. CDC.gov. Retrieved May 14, 2016 from http://www.cdc.gov/bloodpressure/index.htm
Counterbalance of Sugar and Fat Content between Insulin and Glucagon
Physical survival depends on the sustained availability and use of energy in the form of adenosine triphosphate or ATP from sufficient levels of a substance, called glucose (owen, 2001). The use of energy depends on the varying levels of activity. Hence, the amount of glucose needed for activity likewise varies each day. Too much or too little glucose is damaging to the body, hence the need for some system to regulate the availability of glucose. It must be present at the precise time and amount that it is needed in order to maintain what is called glucose homeostasis. Homeostasis is the tendency of the body to maintain internal stability and balance through the coordinated responses of body parts to stimuli or conditions (owen).
Insulin and Glucagon
The regulation of glucose availability begins with the pancreas, primarily by…
Biomed (2002). Insulin/glucagons. Brown University. Retrieved on November 25, 2013
Bowen, R.A. (2001). Hormones, receptors and control systems. University of Colorado.
Retrieved on November 25, 2013 from http://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/basics/index.html
Montefiore Medical Center (MMC): A Case Study
This study reviews a Harvard Business School case on Montefoire Care Centers. The Balanced Scorecard is chosen for the strategic management initiative at Montefoire and the reasons and results of such a choice is reviewed in this case study.
The objective of this study is to answer the question of what were the underlying reasons for the development of a new strategy at Montefiore Medical centre (MMC)? Secondly this study will answer as to how could the strategic direction chosen by MMC be described and what factors likely influenced the chosen direction? This study will compare and contrast the old and the new organizational structures. With reference to the notions of synergy and responsiveness, this study will analyze the advantages and disadvantages or each of these and will explain what is meant by the term causal ambiguity. This work will take the Heart…
Ambrosini, V. And Billsberry (2008) Value Congruence and Its Impact on Causal Ambiguity. 2nd Global e-Conference on Fit. 19th-21st November 2008. Retrieved from: http://www.fitconference.com/2008/fri01.pdf
Michael E. Porter -- The Value Chain (2013) Clint Burdett Strategic Consulting. Retrieved from: http://www.clintburdett.com/process/05_research/research_05_4_valuechain.htm
Montefiore Medical Center (2001) Harvard Business School. 9 Apr 2001.
Porter, ME and Kramer MR (2012) Creating Shared Value. Harvard Business Magazine. Retrieved from: http://hbr.org/2011/01/the-big-idea-creating-shared-value
2012, 1.5 million lives were lost to diabetes globally. It ranked eighth among the causes of deaths across both sexes and fifth among women (WHO, 2016). Higher than optimal glucose levels, even those that fall below diabetes diagnostic threshold, is one of the major causes of morbidity and mortality. Diabetes' diagnostic criterion is fasting plasma glucose ≥ 7.0 mmol/L which is a diagnostic point chosen because of micro-vascular issues such as diabetes retinotherapy. The likelihood of having a macro-vascular disease such as stroke or a heart attack begins to increase even before this point is reached (ellamy, Casas, Hingorani & Williams, 2009). To comprehend the impact blood glucose levels can have on mortality, one ought to view blood glucose related mortality as a risk factor. The total lives that were lost to high blood glucose levels in 2012 have been estimated to be about 3.7 million. The number includes those…
ADA. (n.d.). Statistics About Diabetes. Retrieved from American Diabetes Association: http://www.diabetes.org/diabetes-basics/statistics/?referrer=https://www.google.com.pk/
Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009; 373:1773 -- 1779.
CDC. (n.d.). What Is the National DPP? Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/diabetes/prevention/about/index.html
CDPH. (n.d.). Race/Ethnic Group Differences. California Department of Public Health. Retrieved from: http://www.cdph.ca.gov/programs/ohir/Pages/Diabetes2008Race.aspx
Implementation Process of the EHR Change
In recent time, electronic health records (EHRs) have been carried out by a progressively greater number of hospitals across the globe. At the present moment, the small rural hospital will largely benefit from the implementation of EHRs. The following are the steps that could be undertaken in the implementation process of EHR for the hospital:
1. The first phase would encompass delineating all of the tasks and practices necessitated to be carried out by the physicians, IT staff, as well as practice managers. The fundamental tasks in this phase comprise of scheduling the implementation, patients and practice data migration, formation of a training program and delineating critical success factors and assessment strategies.
2. The implementation committee is thereafter selected. This includes project manager, application analyst and developer, physician advocate, nursing advocate, billing advocate, training managers.
3. Different departments will be involved in…
pag). Some business will continue as usual, of course: Abbott's nutrition division, based in Columbus, Ohio and employing approximately 2,000 people, announced that the nutrition unit will "fall under the umbrella of a new medical products company that will retain the Abbott name in a split announced ednesday" (Rouan n.pag). In addition, the announcement has apparently met with international investor approval: "At the news, Abbott's shares went up 7.3% in premarket trading on ednesday" (M2 Pharma n.pag).
The split is expected to occur in 2012 and will result in the currently-unnamed pharmaceutical company and the diversified medical products company, retaining the name "Abbott" (Abbott Laboratories n.pag).
(a). Pharmaceutical Company:
The pharmaceutical company is projected to have annual sales of approximately $18 Billion, a portfolio including Abbott's high-profile drugs such as Humira and Lupron, and a pipeline of "promising new specialty medicines and formulations" (Abbott Laboratories n.pag). According to Abbott's press…
Abbott Laboratories. A Tradition of Innovation. n.d. Web. 22 October 2011.
-- . Abbott Reports Strong Ongoing Third Quarter Results; Confirms Double-Digit Ongoing Earnings Growth Outlook for 2011. 19 October 2011. Web. 21 October 2011.
-- . Abbott to Separate into Two Leading Companies in Diversified Medical Products and Research-Based Pharmaceuticals. 19 October 2011. Web. 21 October 2011.
-- . Abbott Worldwide. n.d. 2011. Web. 21 October 2011.
Childhood type diabetes and obesity
Which three databases will you use?
Search each database, using key words, for relevant research on this subject. What key words did you use in the Search Strategy fields? nclude all attempts and limitations used to refine your search.
Childhood obesity diabetes
Childhood obesity diabetes
Report the number of citations identified from each database in the number of articles found field.
Select one article from a peer-reviewed nursing journal published within the last three years -- or a germinal article which may contain an earlier publication date -- and provide the citation in APA format.
Hayden, M.R., Joginpally, T., Salam, M., & Sowers, J.R. (2011). Childhood and adolescent obesity in cardiorenal metabolic syndrome and type 2 diabetes: A clinical vignette and ultrastructure study. Diabetes Management, 1(6), 601-614. doi:http://dx.doi.org/10.2217/dmt.11.50
Answer the following questions using your selected research article:
Q1. s this…
I limited the search range for peer-reviewed journals. Also, the journal has a doi; a volume number and serial number; and is authored by research scientists who provided their personal histories and sources of their funding.
Q3. Does this research article generate support for evidence-based practice? If not, state why it does not. Please review the critical appraisal guideline on pg. 466-480.
The authors of the study specifically state that it has implications for evidence-based practice. If adolescent obesity causes permanent changes to the structure of the tissue of sufferers, this has longstanding implications for public policy: it means that adolescents may be unlikely to outlive their parents' generation. Despite numerous improvements in diabetes management, diabetes often suffer severe health consequences. It is imperative that diabetes be thwarted by reducing the likelihood of early-onset obesity, not simply managed in a secondary and tertiary manner after the fact. "This current epidemic-pandemic of CAOO causes a red flag to be raised in order to have primary-care providers become more involved and understand this complex problem. The CAOO pandemic may alter the future course of human disease unless we as primary-care physicians intervene" (Hayden 2011 et al.).
Towards of the goal of fulfilling the mission to "help those we care for to experience the best life possible," nursing services provided at the Sarah Neuman Center include:
Twenty-four nursing in a secure residential setting.
Twenty-four medical coverage supported by onsite and on-call physicians.
Onsite medical specialist consulting services.
Individualized therapy sessions, to include speech therapy, physical therapy, art and music therapy.
Nutritional services supported by staff dietitians.
Onsite pharmaceutical and laboratory services. (Sarah Neuman, para. 9)
Patients that require long-term residential care are often transferred to the Bronx nursing home which provides all of the above services, in addition to highly individualized care services and therapies for "more complex clinical needs" (Bronx, para. 4). These needs include-but are not limited to-progressive Alzheimer's, severe vision impairment, severe speech and swallowing impairments, and chronic kidney disease requiring hemodialysis.
Structural Support of Mission
That each facility essentially provides the same services…
"Bronx." jewishhome.org. Jewish Home Lifecare, 2010. Web. 01 January, 2011.
"Manhattan." jewishhome.org. Jewish Home Lifecare, 2010. Web. 01 January, 2011.
"Sarah Neuman." jewishhome.org. Jewish Home Lifecare, 2010. Web. 01 January, 2011.
"Research Institute on Aging." jewishhome.org. Jewish Home Lifecare, 2010. Web. 01 January,
My nutrient report reveals a number of different things. The first thing that is interesting is that the three day period for which I tracked my diet was perhaps not indicative of my normal consumption levels. I was traveling to hang out with friends and as a result, I ate more junk food, exercised less and drank more than I usually would. I was actually surprised when entering the results that I ate burritos on each of the three days. While I do enjoy a nice burrito every now and again, I do not normally eat one every single day. But, the thing about having a nutrition plan is that people often stick to it, and then blow it up for special occasions like travel or holidays, leading to weight gain that can be hard to remove later. So it is important to track one's consumption even while…
Treatment of Addison's disease involves addressing the hormone deficiency using "replacement dose." [NIH] The drugs that are used as replacements for cortisol functions are known as glucocorticoids. Hydrocortisone or Dexamethasone or Prednisone is the drugs of choice. Since blood levels of Hydrocortisone can be directly measured it is an excellent choice for treatment and it makes drug dosage adjustment very easy. [Sarah aker] Patients with Aldosterone deficiency are treated with fludrocortisone (Florinef). Inside the human body the secretion of cortisol is affected by stress. More cortisol is secreted during stress, fever, vomiting, etc. Therefore during periods of stress or physical ailments patients may require additional dosages of cortisol therapy. During sick days it is therefore necessary to consult with the physician, as a higher dose of cortisol therapy is essential. "Sick day rules" are different from normal days for glucocortisoid treatment dosage. Also, if the patient suffers from severe vomiting…
1) NIDDK, 'Adrenal Insufficiency and Addison's Disease', Accessed March 24th 2010, available at, http://endocrine.niddk.nih.gov/pubs/addison/addison.htm#treatment
2) AAFP, 'Addison's disease: What is Addison's disease', Accessed March 24th 2010, Available at, http://familydoctor.org/online/famdocen/home/common/hormone/910.printerview.html
3) NIH, 'Managing Adrenaline Insufficiency', Accessed Mar 25th 2010 available online at, http://www.cc.nih.gov/ccc/patient_education/pepubs/mngadrins.pdf
4) Mark Rosenberg, M.D., 'A stress related Disease you should know about', Accessed Mar 25th 2010, available at, http://ezinearticles.com/?A-Stress-Related-Disease-You-Should-Know-About&id=1189301
detection of the Borna disease virus relating them to the epidemiology.
The first cases of Borna disease were descried in the 17-19th century in Southern Germany. It was discovered to e a fatal disease affecting the neurological systems of horses and sheep, (Ludwig et al., 1985; Durrwald, 1993) causing ehavioral and neurological symptoms. It was proven to e caused y a 2003]
Today it is eing realized that the scope of the disease is not limited to just a few countries as was previously elieved ut encompassed the world. Also it was realized that far from affecting just horses and sheep as was originally thought virus, the Borna Disease Virus (BDV) in the early 1900's y Zwick and his team in Giessen Germany. [Author not availale, it in fact affected other animals and even human eings.[Staeheli, Sauder; Schwemmle, et al., 2000]
Research into the epidemiology and pathogenesis of the BDV…
bibliography. Journal of Veterinary Medicine Series B. 44, 147-184.
3.Staeheli, P., Sauder, C. Schwemmle, M. et al.,. Epidemiology of Borna disease virus, J Gen Virol 81: 2123-2135
4.Author not available,  Diagnostic Methods In Virology, accessed at http://virology-online.com/general/Tests.htm
5. Nakamura, K., Takahashi, H., Shoya, Y., Nakaya, T., Watanabe, M., Tomonaga, K., Iwahashi, K., Ameno, K., Momiyama, N., Taniyama, H., Sata, T., Kurata, T., de la Torre, J.C. & Ikuta, K. . Isolation of Borna disease virus from human brain. Journal of Virology 74, 4601-4611.
6. Zimmermann, W., Durrwald, R. & Ludwig, H. (1994). Detection of Borna disease virus RNA in naturally infected animals by a nested polymerase chain reaction. Journal of Virological Methods 46, 133-143
The author of this report has been presented with a hypothetical situation where a forty-four-year-old patient has contracted scleroderma within her lung tissue. There are many implications to having this medical disorder and they are not limited to the medical realm. Indeed, this report will cover a number of these implications and byproducts including stereotyping by all of society including medical professionals, the overall predisposition for the disease, daily life of scleroderma, comorbidities that might exist or end up happing and social issues such finances, the environment and so forth. While there are a good number of things that can be done to mitigate, treat or even prevent scleroderma, there are a lot of implications that any scleroderma patient must face and it can be very difficult for the patient.
Scleroderma is rare but it can take on many forms. Indeed, while the patient in this…
IDA. (2014). Don't Judge by Appearances - Invisible Disabilities Association - IDA. Invisible Disabilities Association - IDA. Retrieved 4 July 2016, from https://invisibledisabilities.org/ida-books-pamphlets/accessibleparking/dontjudgebyappearances/
Joachim, G. & Acorn, S. (2003). Life with a rare chronic disease: the scleroderma experience. - PubMed - NCBI. Ncbi.nlm.nih.gov. Retrieved 4 July 2016, from http://www.ncbi.nlm.nih.gov/pubmed/12787233
Mayo. (2016). Overview - Scleroderma - Mayo Clinic. Mayoclinic.org. Retrieved 4 July 2016, from http://www.mayoclinic.org/diseases-conditions/scleroderma/home/ovc-20206014
Military.com. (2016). Navy Vet Says She Got Apology Note after Parking in Vets-Only Space. Military.com. Retrieved 4 July 2016, from http://www.military.com/daily-news/2016/06/22/navy-vet-says-she-got-apology-note-parking-in-vets-only-space.html
Although the severities of congestive signs may be similar, medical evaluation should be instructed to determine whether there is accompanying proof of cardiovascular disease. Physical proof of cardiovascular disease contains the narrow pulse pressure, cool arms, and legs, and sometimes changed mentation, with supporting proof sometimes provided by reducing serum sodium level and deteriorating renal function. Cardiovascular disease is frequently difficult to recognize through phone contact but may be suspected when previously effective diuretic increases fail, nurses report lower blood pressure, or patients explain improved lethargy.
Facilitators and barriers to optimal disorder management and outcomes
Environmental factors and cultural beliefs; motivators and hinders
In this case, the client thought he was suffering from a heart attack and feared to come to the hospital. The symptoms had presented for four days before the patient sought help. The patient had been suffering from similar symptoms for the past six months, but thought…
American Association of Cardiovascular (2013). Guidelines for cardiac rehabilitation and secondary prevention programs. John Wiley & Sons.
Bunting-Perry, L.K., & Vernon, G.M. (2007). Comprehensive nursing care for Parkinson's disease. New York: Springer Pub.
Holloway, N.M. (2014). Medical-surgical care planning. Philadelphia: Lippincott Williams & Wilkins.
Gulanick, M. (2007). Nursing care plans: Nursing diagnosis and intervention. St. Louis: Mosby.
The pancreas is an important source of digestive enzymes and fluids, and plays a critical role in regulating blood sugar levels through the production of insulin and glucagon (NDDIC, 2012). Should the pancreas become inflamed there is the risk that the digestive enzymes will become activated within the pancreas, resulting in self-digestion. This disease is known as pancreatitis and even mild cases require hospitalization. This essay will review what is known about pancreatitis in the United States and the clinical guidelines for diagnosis and treatment.
Pancreatitis Pathophysiology, Epidemiology, and Etiology
The digestive enzymes produced by a healthy pancreas are secreted into the small intestine as zymogens, which are enzymes that have their catalytic domain blocked by a peptide group (Berg, Tymoczko, and Stryer, 2002). The intestinal brush border cells secrete enteropeptidase, which removes the peptide blocking the catalytic domain of trypsin. Trypsin then activates the digestive enzymes secreted by…
Amerine, Emmie. (2007). Get optimum outcomes for acute pancreatitis patients. Nurse Practitioner, 32(6), 44-48.
Andris, Abby. (2010). Pancreatitis: Understanding the disease and implications for care. AACN Advanced Critical Care, 21(2), 195-204.
Banks, Peter A. And Freeman, Martin L. (2006). Practice guidelines in acute pancreatitis. American Journal of Gastroenterology, 101, 2379-2400.
Berg, J.M., Tymoczko, J.L., and Stryer, L. (2002). Biochemistry, 5th Edition. New York, NY W.H. Freeman. Retrieved 18 Feb. 2013 from http://www.ncbi.nlm.nih.gov/books / NBK22589/.
Public health screening activities in programs are also essential in ensuring this level of prevention is ensured. A good example is organized screening programs targeted at the community.
The third level of prevention, tertiary prevention, involves bother rehabilitative and therapeutic measures once the person already has the symptoms and signs of the disease. Tertiary prevention has several goals, which include preventing damage and pain that may arise from the disease, slowing down the progression of the disease, preventing the disease from causing complications, giving optimum care to people with signs of the disease, and helping those with the disease to live healthy lives afterwards. A quintessential example of tertiary preventive activities includes treating diabetics to prevent complications that occur as a result of the disease such as liver and kidney failure. Other examples are management of patients with chronic heart disease with therapy and medication, physical and occupational therapy as…
Baker, J.E.L. (1992). Primary, Secondary, and Tertiary Prevention in Reducing Pesticide-Related Illness in Farmers. Journal of Community Health Nursing, 9(4), 245-254. doi: 10.2307/3427201
Flaskerud, J.H. (1992). HIV Disease and Levels of Prevention. Journal of Community Health Nursing, 9(3), 137-150. doi: 10.2307/3427251
Green, M.M. (1971). The Expanded Role of the Public Health Nurse. Canadian Journal of Public Health / Revue Canadienne de Sante'e Publique, 62(2), 147-152. doi: 10.2307/41984635
Ureda, J., & Yates, S. (2005). A SYSTEMS VIEW of HEALTH PROMOTION. Journal of Health and Human Services Administration, 28(1), 5-38. doi: 10.2307/41288055
The intense pulmonary microvasculature branching runs parallel with lung development; however, detailed understanding of their interactions and interactions with various growth factors is elusive (www.emedicine.com).
hat causes BPD is unique to each neonatal situation. However, high levels of extra oxygen can harm the lungs, cause inflammation, and slow or stop the lung growth in babies born very early. Babies who need a high level of extra oxygen for a period of time may develop BPD. Babies who cannot breathe on their own have breathing failure. Many of these babies are put on a breathing machine to help them breathe. The pressure that the machine uses to push the air can irritate the airways and the lungs and cause them to become more inflamed. Also babies can be exposed to infections both in the womb and after birth. Infections in babies born early can harm their less formed lungs and cause…
Driscoll, W. (2003). Bronchopulmonary Dysplasia. Emedicine. Retrieved February
3, 2005 from the World Wide Web: http;//www.emedicine.com.PED/topic289.htm.
What is Bronchopulmonary Dyplasia? National Heart, Lung and Blood Institute Diseases and Conditions Index. Retrieved February 3, 2005 from the World Wide Web: http://www.
recoding a pregnant mother-Based case study. thai primegravida multpara.
This essay is about a process recording for a pregnant mother. Process recording is a written record of an interaction with a client. Pregnant mothers are in danger of any disease but there most alarming gestational diseases; these include hypertension, cardiac disease, anemia, diabetes, hyperemis gravidarum and many more. In this essay am only going to dwell in gestational hypertension.
This is a process recording of a case study of a pregnant mother. Mrs. B is a 16 years old primigravida at 30 weeks gestation and has attended the antenatal clinic three times. All finding were within the normal range until her last visit 1 week ago when her blood pressure was 130/90mmHg.On urinalysis there was no proteinuria. The fetal heart sounds were normal, the fetus was active and uterine size was consistent with dates. She has come to clinic today,…
American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of hypertension. National Guideline Clearinghouse. Available at http://www.guideline.gov/summary/summary.aspx?doc_id=9338 . Retrieved on 11/02/2011
Benson M.D.( 1989) Obstetrician Pearls,.Philadelphia:F.A Davis.
[Best Evidence] Hedderson MM, Ferrara A (.2008) High blood pressure before and during early pregnancy is associated with an increased risk of gestational diabetes mellitus. Diabetes Care. Dec 31(12)
Chobanian AV, Bakris GL, Black HR, et al. (.2003) The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 289(19):2560-72.
However, what was once a slow journey has recently gathered momentum with the introduction of "more flexible immunosuppression protocols, the ability to individualize surgical options to patient needs, and the dramatic improvement of isolated islet transplantation results." (Allen, p. 3485) esearchers use pancreas transplant options and advanced surgical techniques, but the donor pancreas and surgical complications, as well as the type of immunosuppression affect the outcome of islet transplantation.
The immunosuppressive drugs have significant side effects and long-term effects are still not known. Known side effects of immunosuppressive drugs include mouth sores and gastrointestinal problems, such as stomach upset or diarrhea. Patients also have experienced increased blood cholesterol levels, decreased white blood cell counts, decreased kidney function, and increased susceptibility to bacterial and viral infections. Taking immunosuppressive drugs increases the risk of tumors and cancer as well.
Progress on whole pancreas and beta cell transplantation has been hampered by the…
Allen, R.D.M., et al. (January-February 2000). Pancreas and islet transplantation: an unfinished journey. Transplantation Proceedings. Vol. 33. Nov-Dec 2001.
Clark, W.L. (January-February 2000). Beta cell replacement and islet transplantation. Diabetes Self-Management. Vol. 17(1): pp. 52, 54, 56.
Collazo-Clavel, M., ed.. (2001). Mayo Clinic on Managing Diabetes. Rochester, MN: Mayo Clinic.
Faustman, D. (December 2004). Towards a cure for type 1 diabetes (and other autoimmune diseases?). Infocus. 12(4): 1.
Its use on those with acute PAH should be performed with caution. The complication rate was observed at 2%
in patients with acute PAH. The use of the procedure was deemed relatively safe for chronic pulmonary arterial hypertension. Severely ill patients should be subjected to non-invasive imaging method exhaustively before resorting to pulmonary angiography (Hofman et al.).#
Albert, Nancy M. Caring for Patients with Pulmonary Hypertension. Nursing:
Springhouse Corporation, May 1999. Retrieved on April 25, 2009 from http://findarticles.com/p/articles/mi_qa3689/is_199905/ai_n8846566/?tag=content;col1
adesch, David, et al. Medical Therapy for Pulmonary Arterial Hypertension.
131 (6). Chest: American College of Chest Physicians, July 20, 2007. Retrieved on April 25, 2009 from http://www.medscape.com/viewarticle/560041
Flattery, Maureen P. And Kathy M. aker. Evidence for Racial Disparity in Cardiac
Transplantation Survival Rates. Journal of Cultural Diversity: Tucker Publications,
March 22, 2004. Retrieved on April 26, 2009 from http://findarticles.com/p/articles/mi_m)MJU/is_1_11/ai_n6183827/?tag=content;col1
Hofman, Lawrence V., et al. Safety and Hemodynamic Effects of Pulmonary…
Albert, Nancy M. Caring for Patients with Pulmonary Hypertension. Nursing:
Springhouse Corporation, May 1999. Retrieved on April 25, 2009 from http://findarticles.com/p/articles/mi_qa3689/is_199905/ai_n8846566/?tag=content;col1
Badesch, David, et al. Medical Therapy for Pulmonary Arterial Hypertension.
131 (6). Chest: American College of Chest Physicians, July 20, 2007. Retrieved on April 25, 2009 from http://www.medscape.com/viewarticle/560041
Untreated diabetes can result in serious deterioration of the circulatory system as a consequence of long-term exposure to elevated blood glucose levels (NIDDKD, 2006). By monitoring blood glucose levels and administering insulin to reduce glucose concentration in the blood, many patients can carry on with their lives without significant effects of the disease (ADA, 2009).
However, undiagnosed or untreated diabetes can have very serious effects on the body and consequences for the patient. Among those effects and consequences are kidney damage, cardiac and circulatory system damage, as well as vision problems leading to increasing blindness (ADA, 2007; ADA, 2009). Because untreated or insufficiently managed diabetes often results in decreased circulation to the extremities, diabetes is also associated with the significant risk of losing fingers, toes, and even arms or legs. Once circulation is reduced below the minimum level required to oxygenate tissues enough to sustain them, the patient is at…
American Diabetes Association. (2007). "Diabetes and women's sexual health"
Retrieved July 31, 2009, from: http://www.diabetes.org/type-1-diabetes/women-sexual-health.jsp .
American Diabetes Association. (2009). "Standards of medical care in diabetes"
Retrieved July 31, 2009, from:
Mold Spore Trapping
Current Scientific Knowledge
People are exposed to aeroallergens in a variety of settings, both at home and at work. Fungi are ubiquitous airborne allergens and are important causes of human diseases, especially in the upper and lower respiratory tracts. These diseases occur in persons of various ages.
Airborne spores and other fungi particles are ubiquitous in nonpolar landscapes, especially amongst field crops, and often form the bulk of suspended biogenic debris. The term mold often is used synonymously with the term fungi. A more precise definition would specify that molds lack macroscopic reproductive structures but may produce visible colonies. Respiratory illness in subjects exposed to rust and dark-spored imperfecti fungi was described more than 60 years ago, and physicians worldwide now recognize a sensitization to diverse fungi.
Since fungus particles commonly are derived from wholly microscopic sources, exposure hazards are assessed largely through direct sampling of a…
Brinton, W.T., Vastbinder, E.E., Greene, J.W., Marx, J.J., Hutcheson, R.H., Schaffner, W. (1987). An outbreak of organic dust toxic syndrome in a college fraternity. Journal of the American Medical Association 258:1210-1212.
Ceigler, A., & Bennett, J.W. (1980). Mycotoxins and Mycotoxicoses. Bio-Science 30:512-515.
CDC. 1994. Acute pulmonary hemorrhage/hemosiderosis among infants -- "Cleveland, January 1993-November 1994. Morbidity and Mortality Weekly Report (MMWR) 1994; 43:881-3.
CDC. 1997. Update: Pulmonary hemorrhage/hemosiderosis among infants -- "Cleveland, Ohio, 1993-1996. MMWR 1997; 46:33-35.
Air pollution pertains to substances and gases in the air that threaten health and life. Among these are pollutants and irritants, such as nitrogen oxides, sulfur dioxide, and carbon dioxide; particulates, volatile organic compounds (VOCs), toxic substances and some natural substances, like pollen. ut most of the pollution comes from the by-products of industrialization - fossil fuel combustion, transportation, transportation, power plant emissions and those from other industrial processes. The burning of fossil fuels to generate electricity alone is the greatest source of air pollution in the U.S.A. These outdoor pollutants can undermine health and cause environmental disturbances, such as acid rain, and are toxic.
Studies show that we now spend more than 90% of our lives inside buildings and other constructed environments. ecause of this, such structures - including homes and office buildings - are constructed with energy efficiency and comfort foremost in mind. The installation of central heating,…
1. Alpha nutrition Programs. Indoor Air-More Contaminated Than Outdoor Air?
2. Ammann, Harriet M. Is Indoor Mold Contamination a Threat to Health?
Office of Environmental Health Assessments, Washington State Department of Health
.'s secretions, administration of I.V. fluids to keep B.. hydrated, and, prior to hospitalization, the administration of albuterol.
B..'s breathing was labored and was not significantly improved by the interventions, although suctioning to clear the airways and the introduction of oxygen ensured adequate oxygen intake. Postiaux et al. found that the addition of prolonged slow expirations and provoked coughs could contribute "actively to a direct and immediate drainage of secretions" (2011). This might have helped alleviate "some bronchial obstruction symptoms that are usually associated with an increased load of breathing, due to a positive intrathoracic pressure and an increased respiratory rate" (Postiaux et al., 2011).
Potential Long-Term Effects / Complications
An early and severe infection with SV bronchiolitis is associated with breathing difficulties such as asthma, wheezing, and atopy later in life (Todd et al., 2010). Whether the SV causes these problems or whether a common factor makes infants more…
Essouri, S., Durand, P., Chevret, L., Balu, L., Devictor, D., Fauroux, B., & Tissieres, P. (2011).
Optimal level of nasal continuous positive airway pressure in severe viral bronchiolitis. Intensive Care Medicine, 37, 2002-2007.
Fitzgerald, D. (2011). Viral bronchiolitis for the clinician. Journal of Paediatrics and Child
Health, 47, 160-166.
Type I diabetes is usually diagnosed in children and young adults and results from the body's failure to produce insulin. Type 1 account for 5% to 10% of all diagnosed cases of diabetes (Centers for Disease Control, National Diabetes Fact Sheet, www.cdc.gov/diabetes/pubs/pdf/ndfs_2003.pdf). The most common form of diabetes is Type II, which accounts for about 90 to 95% of all diagnosed cases of diabetes (Centers for Disease Control, National Diabetes Fact Sheet, www.cdc.gov/diabetes/pubs/pdf/ndfs_2003.pdf). Pre- diabetes is a condition often present prior to the development of Type II diabetes. In pre-diabetes, blood glucose levels are higher than normal, but not high enough to be considered diabetic.
Pre-diabetes does not have to lead to the development of diabetes if a person diagnosed with this condition: Patients who work to control their weight and increase their physical activity can often prevent or delay the onset of diabetes. There are 41 million Americans…
American Diabetics Association. Retrieved 22 March 2010 from http://www.diabetes.org/diabetes-basics/diabetes-statistics/
Centers for Disease Control, National Diabetes Fact Sheet.Retrieved 18 March 2010 from www.cdc.gov/diabetes/pubs/pdf/ndfs_2003.pdf
Australian Tax on Wine
usiness Submission - Australian Tax on Wine
With the Australian government seeking to impose additional taxation upon the use and sale of wine, there have been many outcries of indignation arguing how this would affect the Australian wine industry, and eventually the Australian economy. However, what needs to be considered are the consequences and the public cost of continuing with the discounted taxation to which wine makers in Australia are currently subjected to. The effect on the Australian GDP needs to be taken in to account with the harms that alcoholism in the increasingly youth population is set to unleash, if made available readily and at subsidized prices.
The risks and problems that have arose from the increased alcohol consumption by the Australian public in recent years, especially the young generation, point towards a possible increase in the health deterioration of most Australians while also impacting…
ABS. (2013, February 22). Australian Wine and Grape Industry, 2011-12. Retrieved from Australian Bureau of Statistics: http://www.abs.gov.au/ausstats/[email protected]/mf/1329.0
Anderson, K. (2010, May). Reforming taxes on wine and other alcoholic beverage consumption. Wine Economics Research Centre Working Paper No. 0810 . Australia: University of Adelaide.
Andrews, T. (2013). Stop the wine Supertax! Retrieved from Australian Taxpayers' Alliance: https://www.taxpayers.org.au/nowinesupertax/
Government, A. (2011). Australian National Preventive Health Agency. Retrieved from australia.gov.au: http://australia.gov.au/directories/australia/anpha
Elderly in Monrovia, CA
The population of people aged 65 years or greater is steadily escalating, as baby boomers come of age. It is estimated that this age bracket accounts for 10% of the total world population, and is statistically increasing. As this sector of the population steadily increases, there are of course, accompanying health care issues: osteoarthritis, cardiac and kidney issues, Alzheimer's or dementia, and an ever-growing problem with depression. For this essay, we will concentrate on several health issues that plague seniors nationally, but will specifically focus on the aging population over 65 in Monrovia, California.
Monrovia is a smallish city located at the foothills of the San Gabriel Mountains in the San Gabriel Valley, Los Angeles County. Monrovia was settled in the late 1800s as a central hub for the growing orange grove industry, but has now become more of a bedroom community that supports the urban…
Breathe California of Los Angeles County. (2009). Cited in:
California Department of Public Health. (June 2009). "Healthy California -- 2010
Midcourse Review." Executive Summary. Cited in:
Target Group and their Local Government
To determine the actual effects of diabetes on the indigenous population, you must examine the areas where many of these individuals live. This will provide insights as to possible issues that could be contributing to the problem by: examining the policies of the local government, looking at relevant health statistics, determining fruit / vegetable consumption and looking at the different support services / infrastructure. These different elements are important, because they provide insights about how the local community could be contributing to the problem. If you can see how these factors are affecting a particular community, then the government can begin to design intervention strategies to reduce the overall effects. Once this takes place, is when you can see how this demographic of 25 to 64-year-olds can be effectively targeted for an intervention.
A description of the Local Government and relevant socio-demographic characteristics of…
Aborigonal Health, 2010, MMHR, viewed 16 August 2010
Age Structure, 2009, City of Onkaparinga, viewed 17 August 2010
Australia's Health, 2008, AIHW viewed 15 August 2010,
Chronic Conditions, 2009, City of Onkaparinga, viewed 17 August 2010
It should not be taken with aspirin or other aspirin-like compounds. It should not be taken with, "benzodiazepines, flecainide (Tambocor), iron, ketoconazole (Nizoral), lithium (Eskalith, Lithobid), methenamine (Hiprex, Urex), methotrexate, quinidine, sulfa-containing antibiotics, tetracycline (Sumycin), or vitamins" (4). It can exacerbate certain conditions such as high blood pressure, congestive heart failure, kidney disease, or ulcers (4). It should be consumed while pregnant or breastfeeding, only under the direction of a physician (4). Sodium is used to increase the effectiveness of sulfanomides (5).
Sodium bicarbonate increases the sodium level in the body (4). A physician might prescribe a low or reduced sodium diet while on Sodium bicarbonate. The individual needs of each patient must be addressed by their own personal physician. Sodium carbonate can produce certain side effects in some people. These side effects include increased thirst, stomach cramps, and extra gas (4). Several symptoms may indicate serious conditions for which…
1. JTBaker. "Sodium Bicarbonate: Material Safety Data Sheet." http://www.jtbaker.com/msds/englishhtml/s2954.htm (accessed 25Mar07).
2. Solvay Chemicals. "Sodium Bicarbonate: Material Safety Data Sheet." http://www.solvaychemicals.us/static/wma/pdf/6/7/5/9/SODBICARB.pdf (accessed 25Mar07).
3. Holleman, a. And Wiberg, E. "Inorganic Chemistry" Academic Press: San Diego, 2001.
4. American Society of Health-System Pharmacists, Inc., "Sodium Bicarbonate" http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682001.html (accessed 25Mar07).
Essential hypertension or primary hypertension is a highly complex disorder. There are various factors modulating BP or blood pressure in order for adequate tissue perfusion to occur. These include:
Circulating blood volume
Blood vessel elasticity
History of high blood pressure in family
Aside from these factors, the natural course of primary hypertension is progression from infrequent or occasional to established or frequent hypertension. There is a long, asymptomatic, and invariable period when the persistent hypertension then progresses into complicated hypertension. This means there will be target organ damage to the small arteries and aorta, retina, heart, kidneys, and central nervous system.
The journey to primary hypertension begins with prehypertension from ages 10-30 years. The transition to early hypertension occurs from ages 20-40 years. During this phase peripheral resistance is noticeable. After this stage is established…
Bolivar, J. (2013). Essential Hypertension: An Approach to Its Etiology and Neurogenic Pathophysiology. International Journal Of Hypertension, 2013, 1-11. http://dx.doi.org/10.1155/2013/547809
MacGregor, G., & Kaplan, N. (2010). Hypertension. Abingdon: Health Press.
Mayo Clinic,. (2016). Overview - Creatinine test - Mayo Clinic. Mayoclinic.org. Retrieved 29 February 2016, from http://www.mayoclinic.org/tests-procedures/creatinine-test/home/ovc-20179389
Podzolkov, A., & Fadeyev, V. (2009). Hypothyroidism, Subclinical Hypothyroidism, High-normal TSH-level. Clinical And Experimental Thyroidology, 5(2), 4. http://dx.doi.org/10.14341/ket2009524-16
This is the strategy used in Canada, where drug costs have been substantially reduced.
The challenges presented by this law have spilled over into the current health-care reform debate. Many people and many legislators who might have been more open to engage in productive dialogue during the current debate were no doubt made more leery of the process and of the possibility that there could be significant reform that would bring benefits to more people while bringing down the federal deficit.
The fears of opponents of the bill were correct in their fears that the bill would been even more expensive than originally budgeted. The initial estimate for the net cost was $400 billion for the period from 2004-2013. However, only a month after the bill's passage, that estimate was raised to $534 billion. It has since been raised to over $550. The cost over-runs in this bill will no…
Government Policies and Market Issues Impacting Organ Donations in the United States
While organ donations such as hearts, lungs and kidneys represent a potential life-saving gift for thousands of Americans each year, it remains unclear whether some information approaches increase the rate of organ donation more than other approaches. The purpose of this study is to determine whether or not knowledge-based or value expression-based approaches identified in survey research as positively related to organ donations are significant in field research. From January 2009 to April 2009 over 20,000 citizens of the District of Columbia will be given brochures on organ donations when they obtain a new or renewed driver license at the Department of Motor Vehicles. Each brochure focuses on one of three information approaches: (1) information directed at improving understanding of the need for organ transplantation, (2) information directed at dispelling organ transplantation myths, or (3) information directed at…