Category: Disease

Introduction

The two screening tools under analysis are STI Screening and NAT Testing. Sexually transmitted diseases are one of the most dangerous as they might spread very quickly. To identify the most relevant tool for disease detection and prevention, it seems necessary to properly examine both of them.

STI Screening

STI Screening is associated with highly sensitive screening tests, in other words, they almost do not give false-negative results. The Sexually Transmitted Infection (STI) Screening system uses artificial HIV proteins that detect specific antibodies developed by the body in response to viral proteins (Zenilman & Shahmanesh, 2012). Once antibodies are trapped, they can be identified by reagents that are used together with an indicator such as an enzyme resulting in the change of color. Changes in the color are read by a machine determining the result. Speaking of the odds ratio, the STI Screening can identify HIV infection in 3-5 weeks after the contamination in most cases. The specificity of the STI Screening identifies whether the person has a disease or not. However, the identification of different diseases requires different tests. The positive predictive value (PPV) of the screening is 50 percent while the negative predictive value (NPV) is five percent.

NAT Testing

Another type of screening tool is Nucleic Acid Testing (NAT) that is also known as Nucleic Acid Amplification Testing (NAAT). It is used for the amplification of HIV RNA to facilitate the identification of the virus. Due to the extremely high sensitivity of NAT tests, a window period is short, but there are frequent false-positive results. In particular, the PPV of the tool consists of 60 percent, and the NPV is 7 percent. Therefore, positive results should be confirmed by applying a standard test for HIV as soon as possible. Given the high cost of NAT tests, they do not use regularly and are not cost-effective for testing large groups of people. As a rule, NAT tests are used for the detection of HIV in infants and blood banks. What is more, they are significant for the diagnosis of primary or recent infections. The specificity of the tool is 98 percent (Zenilman & Shahmanesh, 2012). The odds ratio is approximately 11 days (Hans & Marwaha, 2014).

Additional Means to Evaluate Screening Tools

It is also useful to apply the Open Source Epidemiological Statistics for Public Health tool while assessing the effectiveness of screening tools. After receiving the necessary information, it might be compiled and entered into so-called 2×2 contingency tables. Tables are intended to conduct further statistical processing of materials by comparing two samples. Among confounders, in other words, variables that distort results of the screening, one might note age or related diseases. A properly designed study eliminates confounders in the case if the researcher knows the object of the study and constantly expects the occurrence of errors. Nevertheless, there are such effect modifiers as age or immunization. The effect modifier alters the initial causative factor. For instance, age is an effect modifier in plenty of diseases or the immunization that modifies consequences of exposure to infectious agents.

Conclusion

In conclusion, we consider that described tools are rather significant and useful to identify and prevent the spread of sexually transmitted diseases. Besides, it seems appropriate to investigate the above topic among 20-35 age groups with different ethnicities and incomes as they are exposed to the disease more than others. We believe that the logic on the decision of screening tools is appropriate as they are relevant and successfully used in nowadays medicine. Speaking of the defined confounders and interactions, we agree with the decision because it reflects principal aspects.

References

Hans, R., & Marwaha, N. (2014). Nucleic acid testing-benefits and constraints. Asian Journal of Transfusion Science, 8(1), 2-3.

Zenilman, J. M., & Shahmanesh, M. (2012). Sexually transmitted infections: Diagnosis, management, and treatment. Sudbury, MA: Jones & Bartlett Learning.

With the recently discovered coronavirus and a pandemic caused by it, many people found themselves dependent on public health services. The main strategies generally used in public health to control the incidence of disease include medical countermeasures and public health interventions (Institute of Medicine et al., 2007). Vaccination is one of the most important and commonly used therapeutic countermeasures. Vaccines allow the body to build stronger natural defenses, and, therefore, fight infections. With their help, the immune system is able to create special proteins, or antibodies, that naturally develop after the exposure to the disease. Antiviral medications are also commonly used to prevent infections, as well as stop the infection process after it has started. With the help of antiviral drugs, the human body can stop the virus from attaching to the cells, and instead make it attach to the medication.

On the other hand, public health interventions include travelling and border control, quarantine, isolation, and other social separation strategies. Border control implies border screening, which is done to slow down the spread of disease by preventing infected persons from entering or leaving a country or region. Quarantine and isolation are the oldest known methods to control the spread of contagious diseases. When infected individuals are confined to their homes or some designated facilities, disease incidence becomes easier to monitor and control (Institute of Medicine et al., 2007). Social separation approach is mostly presented by social distancing policies, which introduce certain restrictions in public gathering places. This generally results in the closing of schools, markets, workplaces, and other facilities, as well as in cancelling most of the public events. Slowing down the spread of diseases, public health interventions can buy time for the development of medical countermeasures and prevent the health-care system from being overwhelmed with large numbers of patients.

References

Institute of Medicine, Board on Global Health, & Forum on Microbial Threats. (2007). Ethical and legal considerations in mitigating pandemic disease: Workshop summary. National Academies Press.

Introduction

I chose these two articles since they give a detailed explanation and description of the Salmonella disease. The articles give comprehensive details of the signs and symptoms of the disease. They also provide information about whether there was an outbreak of the disease and what was linked to it. Centers for Disease Control and Prevention gives the outbreaks years and whether they were linked to animals or food (2022). This provides researchers with extensive details about the illness, its outbreak, and possible patterns to prevent future outbreaks.

Discussion

From the articles, I learned that Salmonella is caused by a bacterium known as Salmonella. One gets the infection by touching infected animals or their environment, eating contaminated food, or drinking contaminated water. The infected person experiences symptoms of diarrhea, fever, and stomach cramps within six hours to six days after infection and can go on for a week after infection (CDC, 2019). I also learned that a laboratory test is the only way to test for Salmonella. The test is conducted on the persons stool, body tissue, or fluids (CDC 20222). Once the disease is detected, it can be treated with antibiotics for a prescribed period.

Conclusion

Some elements and terms related to the final project found in the articles are bacteria, infection, diagnosis, and treatment. The connection with the final project is the disease itself and the outbreaks outlined in the articles. Since public health practitioners rely on epidemiology to understand more about health conditions and diseases, such as the risks and protective factors, these articles may be helpful in evaluating the patterns of Salmonella outbreaks in the Caribbean. It will also be helpful in identifying if there is a specific population that is at risk of infection.

References

Centers for Disease Control and Prevention (CDC) (2019). Reports of Selected Salmonella Outbreak Investigations, U.S. Department of Health and Human Services.

Centers for Disease Control and Prevention (CDC) (2022). Question and Answers Salmonella, U.S. Department of Health and Human Services.

Heart related diseases are caused by many factors and they are becoming common in pregnant women. The presence of cardiac disease during pregnancy poses a challenging clinical situation to medical doctors because they are also supposed to concentrate on the wellbeing of the unborn baby (Perry etal. 2011). During this time when the mother is pregnant, profound changes occur in the blood circulation, which may adversely affect the health of the mother and that of the unborn baby (Perry etal. 2011). This situation may even get worse if there is presence of underlying heart conditions in the mother. The prevalence of cardiovascular complications among pregnant women has been estimated to be 4 percent, and according to recent research, maternal heart diseases and other heart complications are among the main causes of death in pregnant women. Research has also shown that patients who have undiagnosed heart diseases are likely to have complications or even die during the pregnancy period.

Diagnosis of heart diseases

During pregnancy, there is an increased demand of blood in the body for the mother and unborn child (Sahni, 2012). The increased demand puts a lot of pressure on the heart and circulatory system making pregnant women prone to cardiovascular diseases. The blood demand during pregnancy is 50 percent compared to 30 percent for people who are not expectant (Sahni, 2012). Therefore, the heart has to work extra hard to meet the required demand in the body, which affects the cardiovascular system.

The cardiovascular system is vital because it keeps body organs supplied with oxygen for proper functioning (Sahni, 2012). However, because of some reasons some of the arteries and veins may become impaired making them unable to perform their functions as expected. This impairment leads to cardiovascular diseases, which are different and vary in the way they affect the heart. The impairment can be caused by poor lifestyle, alcohol and tobacco use, obesity, physical inactivity and poor eating habits (Perry etal. 2011). One of the diseases that occur because of cardiovascular system impairment is called coronary heart disease. This condition can be fatal during pregnancy because it causes high blood pressure that causes many maternal deaths.

Diagnosis of heart diseases during pregnancy can be done through checking patients medical history, physical examination, and chest examination (Sahni, 2012). Carrying out tests during pregnancy remains the best way to detect a heart disease. In addition, tests can be used to check the general function of the heart (Sahni, 2012). However, it is good to note that x-rays should not be used to get chest films because they can affect the development of the fetus. Nevertheless, an electrocardiogram (ultrasound) is efficient in identifying any irregularities in the heart rate, arrhythmias and detects any past heart problems (Northwestern Memorial Hospital, 2012).

In addition, Cardiac Event Monitors are used on women who have palpitations to determine any abnormality in the heart. The use of Cardiac Monitors enable doctors to check any changes taking place in the heart by monitoring the heart beat in hours or days (Ignarro, Balestrieri, and Napoli, 2007). This helps to detect heart condition, which occurs infrequently and can go undetected if doctors are not keen during this period. Another form of checking the heart during pregnancy is based on ultrasound that has no negative effects on unborn babies (Sahni, 2012). The ultrasound can be combined with a Doppler to determine functioning of the valve throughout the pregnancy period (Northwestern Memorial Hospital, 2012). Other problems that are checked during pregnancy that are associated with the heart include heart infection, blood clots among others. These kinds of problems are only seen through a (TEE) transesophageal echocardiogram (Sahni, 2012). It has been discovered that most heart attacks are a result of blockage in the blood vessels.

Etiology of cardiac disease during pregnancy

Complication of the heart during pregnancy is common and it is therefore, important for pregnant women to understand the risks involved. The pregnancy itself is a source of stress to the heart and the circulatory system (Northwestern Memorial Hospital, 2012). Because of this kind of stress, complications are most likely to occur during this delicate period. Even though, a big number of pregnant women who have heart problems deliver hale and hearty babies. However, in the majority of underdeveloped countries and developing countries, rheumatic disease is one of the major causes of maternal heart diseases (Sahni, 2012).

There are several reasons why cardiac diseases are common in pregnant women. One of the reasons is improved or better health care. Because of better and improved care in the hospitals, women who have heart-related problems are living a healthy life and they survive up to reproductive age (Ignarro, Balestrieri, and Napoli, 2007). It is only during the pregnancy that these complications emerge with full force. The second cause of cardiac disease in pregnant women is changes in demography, which have caused an increase of prevalence in regions with large number of immigrants (Ignarro, Balestrieri, and Napoli, 2007). The third reason why cardiac diseases are common among pregnant women is the tendency to delay motherhood until the third decade (Northwestern Memorial Hospital, 2012). Poor lifestyle, especially unbalanced diet and lack of exercise is another cause of cardiac disease in pregnant women. It has been proved that unbalanced diet may cause obesity, which is a major risk factor for cardiac disease. Other major causes include aortic dissection and myocardial infarction, which makes the heart vulnerable.

Signs, Symptoms, and Causes of the Disease/Disorder

There are different types of heart diseases, which may affect individuals. Pregnant women also suffer a number of heart related problems (Ignarro, Balestrieri, and Napoli, 2007). Current research findings reveal that approximately 90 percent of pregnant women with heart related problems had rheumatic heart disease (Northwestern Memorial Hospital, 2012). The main causes of rheumatic diseases are injuries to the heart and valves, which is brought by rheumatic fever (Northwestern Memorial Hospital, 2012). According to medical experts, rheumatic fever is not a common condition, although it is a serious clinical condition that can cause serious damages. It is caused by bacteria known as streptococcus, which can be treated using antibiotics. Because medical doctors are able to address the problem of rheumatic fever, the percentage of pregnant women with heart disease caused by rheumatic fever is relatively low, especially in the last 10 years (Ignarro, Balestrieri, and Napoli, 2007). Today, the major causes of cardiac diseases among pregnant women are congenital heart conditions and cardiovascular disease. These conditions are more prevalent and are evident in every 1 out of three woman with heart diseases.

There are several symptoms of heart conditions. Some of most common include difficulty in breathing, feeling dizziness and constant chest pains (Northwestern Memorial Hospital, 2012). Other patients may experience dizziness and lightheadedness combined with constant fainting. The presence of these symptoms varies according to level of defects. For instance, less serious congenital heart deficiencies are not easily detected at early stages. In most cases, these defects are only diagnosed at later stages (adulthood). Pregnant women with these defects have symptoms like short breath/ breathing problems, they get tired even after performing simple activities, and they swell in the hands and feet.

On the other hand, a cardiac disease is also another problem experienced by pregnant women. There are varies symptoms that may occur during the pregnancy period; some of the most common include constant fainting, chest pains, shortness of breath, feeling weak (fatigue), having breathing difficulties when sleeping, and constant shivering may also occur. Fainting may occur constantly due to high blood pressure and change of blood volume during the pregnancy. Difficulties in breathing and shortness in breathing may be caused by enlarging uterus as the pregnancy advances (Perry etal. 2011). Palpitations during pregnancy may be caused by change in position of the diaphragm as the fetus grows. Because of change in the blood volume, most pregnant women may develop problems in the heart beat, which can be indentified through cardiac testing (Ignarro, Balestrieri, and Napoli, 2007). Although most women develop swelling of feet and hands during this delicate stage, it is not entirely caused by heart complications (Perry etal. 2011). Because of the fact that heart diseases are many, the doctor should diagnose the patient to know which type of disease his/her patient is suffering from.

Treatment and Prognosis of heart disease among pregnant women

Most heart diseases are easier to treat and manage, especially if they are detected early enough (Perry etal. 2011). Therefore, pregnant women who feel as if they have heart problems, whether judging from the general symptoms and signs; they should consult professionals immediately. In addition to this, it is highly advisable that all expectant mothers should go for regular health check ups during the whole period of pregnancy. In fact, pregnant women are advised to talk to their doctors in regard to any concerns one has about their heart and general health. If a patient does not have an already existing heart condition, she should see the doctor immediately, especially if one continues to experience breathing difficulties, shortness in breathing, constant chest pains and fatigue (which are the most common indicators of heart problems). In addition to this, women who have family members that have been diagnosed with heart related problems should also visit hospitals to be evaluated on a regular basis. This is because history of heart disease in family/ relatives is an important factor that should be put in consideration during the pregnancy.

Because of complications related to heart diseases, pregnant mothers should have frequent prenatal visits (Perry etal. 2011). This is extremely important because good patient cooperation and doctors care can help. In case of cardiovascular problems, medical therapy should only be conducted by trained specialists (cardiologist, obstetricians, and anesthesia care providers). During the pregnancy, the classification of the heart disease may advance from level 1 to level 4, which increase chances of miscarriage or complication at the time of birth.

Preconception counseling is also important part of the treatment. This is because some heart diseases, especially those that are congenital can result in congenital lesions to babies. Management of the cardiovascular diseases is important and it mainly focuses on preventing hypotension and increased heart beat (Perry etal. 2011). At the second stage, the disease should be managed through operative vaginal delivery (Perry etal. 2011). It is important to note that caesarian section should only be performed for women with obstetric issues.

In addition to this form treatment, there is a need to provide nursing care management for pregnant women so that they can recover quickly. When providing this kind of care, the doctors should combine routine peripartum care with special interest in cardiac analysis. This is essential to know the progress. The management of this problem can be addressed by strategizing on how to minimize stress on the heart. It is important to understand that the heart is more stressed between 28 and 32 weeks of pregnancy. It is therefore, significant to treat the pregnant mother against anemia, emotional stress, hypertension, and obesity, which are the main causes of stress to the heart (Ignarro, Balestrieri, and Napoli, 2007). The doctor should also encourage the pregnant mother to take a balanced diet containing high levels of iron. The mother should also be provided with folic acid (as a supplement) calories, and adequate proteins, which will help the patient to gain weight (Perry etal. 2011). The doctor should also recommend the patient to take more water. When providing cardiac medications, the doctor should also consider the wellbeing of the unborn baby. After prescribing drugs, the doctor should monitor the patient on regular basis to determine whether the drugs are affecting the fetus.

Conclusion

There are different types of heart disease, which may affect individuals. Pregnant women also suffer a number of heart-related problems and the most common one is cardiovascular disease. Heart related diseases are becoming more common in pregnant women due to several risk factors. Today, improved health care, postponing motherhood until third decade, and poor lifestyle are among the reasons why cardiac disease is common in pregnant women. The presence of cardiac disease during pregnancy poses a challenging clinical situation to medical doctors because they are also supposed to concentrate on the wellbeing of the unborn baby. Because complications of the heart during pregnancy are common, it is extremely important for pregnant women to understand the risks involved. Since the pregnancy is a source of stress to the heart and the circulatory system, doctors should strive to manage this stress. There are several symptoms of heart conditions and some of most common include difficulty in breathing, feeling dizziness and constant chest pains. Other patients may experience dizziness and lightheadedness combined with fainting (Perry etal. 2011). The presence of these symptoms varies according to level of defects. It is also worthy noting that most heart diseases are easier to treat and manage if they are detected early enough. Therefore, pregnant women who feel as if they have heart problems, whether judging from the general symptoms and signs; they should consult health professionals immediately. As part of treatment, the doctor should encourage the pregnant mother to take a balanced diet containing iron. The pregnant mother should also be provided with folic acid, calories, and adequate proteins. The doctor should also advice the patient to take more water. When providing cardiac medications, the doctor should also consider the wellbeing of the unborn baby. After prescribing drugs, the doctor should monitor the pregnant mother on a regular basis to determine whether the drugs are affecting the fetus.

References

Ignarro, L. J,. Balestrieri, M. L., Napoli, C. (2007). Nutrition, physical activity, and cardiovascular disease: an update. Cardiovascular research, 73 (2): 32640.

Northwestern Memorial Hospital (2012). Cardiac signs & symptom during pregnancy. Web.

Perry, S. E., Hockenberry, D., Mariln, J., & Lodwermilk, L. (2011). Maternal Child Nursing Care, (4th edn.). Maryland: Mosby Inc.

Sahni. G. (2012). Cardiovascular Disease in Pregnancy, An Issue of Cardiology Clinics. Philadelphia: Elsevier Health Sciences.

Introduction: Thyroid Gland Disorder and Its Manifestation in an Adult-Gerontology Patient

What makes a thyroid gland disorder (TGD) so big a threat is that it does not manifest itself in a way that makes it easily detectable. Consequently, the symptoms that adult patients display are not that different from the ones that young patients have. As a result, the management of the disorder becomes times more difficult than the process of treating other endocrine conditions. Therefore, due care and attention must be paid to the prevention of the syndrome.

Among the primary symptoms in which the problem manifests itself, one must mention tiredness, dry skin, constipation, and intolerance to cold. However, seeing that the identified issues may also be characteristic of other disorders, one must consider the presence of other issues as well. For instance, bradycardia and carpal tunnel syndrome must also be viewed as the indicators of TGD. When testing young patients, i.e., children and teenagers, for the disorder, one may also consider the symptoms such as short attention span. However, an enlarged thyroid gland is the most common and by far the most certain indicator of the issue (Wang, 2013).

Pathology of the Altered Presentation of the Condition in Adult and old Patients and How It May Manifest Itself in a Non-Adult Patient

The pathology of how TGD is presented in adult and elderly patients are slightly different from the one in which it shows in young people. For instance, adult and senior patients are likely to experience significant elevations in plasma levels. Heart diseases and even possible heart failures should also be viewed as a possible outcome of the disorder in adults. TGD is also likely to trigger the development of macrocytic anemia. Consequently, if left unattended, the issue may evolve to the stage of pernicious anemia. It could also be argued that arthritis-related concerns that adult TGD patients are known to have been linked directly to the subject matter.

Young patients, however, do not develop the identified issues as explicitly as the adult and elderly ones. Furthermore, the mental issues that are said to be comorbid in elderly patients do not typically occur in young people. The latter, however, are very prone to the development of severe depression when fighting TGD. Furthermore, young people may experience significant rhythm disturbances when undergoing the treatment typically suggested for the successful management of TGD.

Comorbidities Affecting the Condition, Treatment Options, and the Necessary Alterations to the Treatment Plan

A recent study on the issues associated with TGD shows that mental disorders are often comorbid with TGD (Upadhyaya, Lamichhane, & Subedi, 2013). Indeed, the research indicates that TGD may manifest itself in an array of ways, and the development of mental disorders is one of the possible comorbidities that may occur in TGD patients.

Furthermore, the research shows quite evidently that there is an obvious connection between the levels of stress in the patients, the presence of TGD, and the progress of mental problems. In other words, the psychological strain under which the target population finds itself leads to a gradual psychological breakdown that results in the rapid progress of a mental disorder or a similar psychiatric issue in TGD patients. Consequently, it would be reasonable to assume that mental issues and TGD are not only comorbid but also linked directly to each other.

Moreover, other thyroid dysfunctions are typically comorbid with TGD. For instance, there is a supposition that hyperthyroidism may occur along with Diabetes Miletus (DM). Even though no direct evidence of the identified comorbidity has not been found, the number of incidences of TGD and DM points to the fact that there may be a link between the two (Wang, 2013).

Considerations for an Acute Care Nurse Practitioner to Take into Account When Addressing the Needs of Adult-Gerontology Patients with a Thyroid Gland Disorder

When managing the TGD-associated issues in adult patients, a nurse must focus on encouraging the target population to take rest often and reduce the stress levels. Seeing that mental issues and the threat of depression become increasingly more possible with the progress of the disorder, it is crucial to introduce the necessary preventive measures. The prevention of cardiac dysfunction should also be viewed as one of the most crucial steps toward meeting the needs of TGD patients efficiently (Belleza, 2016).

Conclusion: Addressing Thyroid Gland Disorder in Adult and Senior Patients

Managing the needs of adult TGD patients is quite challenging due to the Comorbidities associated with the disorder. Nevertheless, general guidelines include the prevention of patients being exposed to cold. Furthermore, the patients should be encouraged actively to consume fluid since TGD may lead to dehydration. A focus on the breathing pattern should also be deemed noteworthy for a nurse addressing the TGD-related problems since heart failure is typical in adult and elderly TGD population. Finally, promoting physical activities is likely to lead to a rapid improvement of the patients condition (Jonklaas et al., 2014).

References

Belleza, M. (2016). Hypothyroidism. Web.

Jonklaas, J., Bianco, A., Bauer, A. J., Burman,, K. D., Cappola, A. R., Celi, F. S&. & Sawka, A. M. (2014). Guidelines for the treatment of hypothyroidism: Prepared by the American Thyroid Association task force on thyroid hormone replacement. Thyroid, 24(12), 1670-1751.

Upadhyaya, T. D. K., Lamichhane, T. L. N., & Subedi, S. (2013). The study of psychiatric disorders in patients with thyroid disorder at the tertiary care centre in western region of Nepal. Journal of Psychiatrists Association of Nepal, 2(2), 29-34.

Wang, C. (2013). The relationship between type 2 diabetes mellitus and related thyroid diseases. Journal of Diabetes Research, 2013(390534), 1-9. Web.

Pathophysiology

Chronic Obstructive Pulmonary Disease (COPD) is a disease that affects the lungs and leads to massive inflammation of the tissues that make up the lungs (Barnes, 2000). Generally, this disease condition results in the blockage of the air passages in the pulmonary compartments. It has been noted that the major cause of this disease is chronic cigarette smoking. However, smoke that comes from other sources is also associated with the development of this disease (Gross, 2003). It has been defined that the disease mainly occurs in coal mines, cotton ginneries, and grain stores.

It has been noted that smoke and dust or other irritants make blood cells (neutrophils and T-lymphocytes) accumulate and cause blockages in the pulmonary airways (Copstead & Banasik, 2009). An inflammatory response is triggered by this phenomenon. In this attempt, an influx of inflammatory mediators moves into these sites to destroy the inhaled debris. Repeated exposure to such irritants triggers the inflammatory response which seems to progress. This leads to the massive destruction of the airways. They narrow and constrict a condition that leads to excessive mucus production which reduces the functioning of the cilia. This makes clearance of the airways difficult, and patients develop persistent coughs and general dyspnea (Gross, 2003). The mucus layer that forms on the airways creates an attractive environment for bacteria that live and multiply in a warm and moist setting. Such bacteria colonize the region and increase in number which results in the development of diverticula and bacterial infection (Copstead & Banasik, 2009).

Treatment

Upon diagnosis of a patient with COPD, special attention should be given to the reduction of the risk factors and amelioration of signs and symptoms through pharmacological and non-pharmacological procedures to optimize the patients functional status and longevity. Focus on risk reduction helps to control the induced inflammatory reactions that continuously damage the airways. This is the first step in managing and treating COPD. Smoking cessation plays a great role in the cure of this disease.

The use of bronchodilators also makes up a basis in the treatment of COPD (Gross, 2003). Some of the most commonly used types include anticholinergics, beta-adrenergic agonists, and methylxanthines (Barnes, 2000). These bronchodilators cause smooth muscle relaxation which enhances effective lung deflation. It also helps to minimize dynamic hyperinflation. Improved thoracic exercise enhances inspiration capacity and helps to remove mucus exudates from the airways. Bronchodilators, therefore, enhance the capacity of regular exercises in COPD patients and consequently improve their condition.

Phosphodiesterase-4 inhibitors are also widely used to fight against COPD. These have been shown to improve the condition by stable exacerbations. The use of corticosteroids has helped as well to cure and improve conditions of COPD patients. It has been observed that inhaled corticosteroids are effective in managing exacerbations (Gross, 2003). Prophylactic immunizations against influenza have been made available to people and have been associated with reduced incidences of COPD (CDC, 1999). It has been recommended that the 23-polyvalent pneumococcal vaccine should be administered to patients with COPD. Antibiotics such as macrolides are effective in fighting bacterial colonies which inhabit the airways. They, therefore, have found expansive applicability in COPD treatment plans. Mucokinetic agents together with corticosteroids have also been used to reduce the levels of exacerbations and auger in the management of COPD (Barnes, 2000).

In conclusion, it should be stated that priority in treating COPD has to be given to the change of lifestyle by avoidance of the irritants that trigger an inflammatory response. It is vital to avoid smoking and dust in the workplace.

References

Barnes, J. (2000). Chronic Obstructive Pulmonary Disease. N Engl J Med, 343(4), 269-80.

Centers for Disease Control and Prevention (CDC). (1999). Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep, 48, 1-28.

Copstead, C., & Banasik, L. (2009). Pathophysiology. St. Louis: Saunders.

Gross, N. J. (2003). Outcome Measures in COPD. Are We Schizophrenic? Chest, 123(5), 1325-1327.

Background and Significance of the Problem

The relationship between hypertension and kidney disease has been disputable for decades. Recent studies suggest that there is a definite link between the two disorders and it has been suggested that the relationship is cyclic (Buffet & Ricchetti, 2012). Buffet and Ricchetti (2012) that hypertension occurs in 85-95% of patients suffering from chronic kidney disease. At the same time, uncontrolled hypertension is a significant risk factor for development of the chronic kidney disease. It has been estimated that hypertension and other cardiovascular diseases account for 50% of deaths in patients suffering from kidney disorders (Kauric-Klein, 2012a). Although it is clear that there is a relationship between two types of disorders, there is still a gap in knowledge when it comes to particular risks associated with hypertension and renal disorder.

It is necessary to add that there is still a gap in knowledge associated with strategies to address the issue and prevent development of renal disease in patients with hypertension. Kauric-Klein (2012a, 2012b) notes that blood pressure knowledge, monitoring and supportive educative nursing intervention have a positive impact on people. However, it is still unclear what role can play a combination of such strategies as medication self-management, blood pressure control and lifestyle modifications in the process of slowing down development of renal disease.

Statement of the Problem and Purpose of the Study

Therefore, there is a definite relationship between chronic kidney disease and high blood pressure. At that, there is a significant gap in the knowledge concerning the nature of the relationship between the two disorders. Risk factors associated with development of the chronic kidney disease in patients with hypertension are still unidentified. There is certain research that suggests certain impact of age, gender as well as ethnicity (Jones, 2014). However, the data reported are quite insufficient and it is essential to evaluate major risk factors. Researchers are also unaware of possible tools to prevent development of the renal disorder in patients with high blood pressure (Buffet & Ricchetti, 2012).

The purpose of this research is to identify the effects of high blood pressure associated with renal disorder and to examine effective strategies to address these effects.

Research Questions

The major research questions of this research can be formulated as follows:

1. Are age, gender, and lifestyle major risks associated with renal disease and hypertension?
2. Will optimal medication self-management, blood pressure control, and lifestyle modifications slow down development of renal impairment in patients with high blood pressure?

Hypothesis

The null hypotheses of the present research can be formulated as follows:

1. There is no risks associated with renal disease and hypertension.
2. Efficient medication self-management, blood pressure control and lifestyle modification will have no effect on development of chronic kidney disorder in patients with high blood pressure.

The research hypotheses can be formulated in the following way:

1. There is a high risk of development of chronic kidney disease in patients with uncontrolled high blood pressure.
2. Efficient medication self-management, blood pressure control and lifestyle modification will slow down or prevent development of chronic kidney disorder in patients with high blood pressure

Variables

To answer research questions, it is possible to identify a number of variables. There will be dependent and independent variables. Since the research is aimed at identifying the impact on the two diseases, major dependent variables will be blood pressure and the rate of the impairment of renal function in patients with hypertension.

As far as independent variables are concerned, these will be age, gender, lifestyle and medication treatment strategies. As has been mentioned above, the purpose of the research is to identify risk factors associated with development of renal disease in patients suffering from high blood pressure. Therefore, age should be one of variables. It is clear that older people are at higher risk of development of the disorders. It is necessary to add that the rising rate of people suffering from the two disorders is associated with population aging (Buffet & Ricchetti, 2012). In the present research, special attention will be paid to age.

Another possible factor affecting development of the disorder can be gender. There is no sufficient evidence that gender is an insignificant factor when it comes to development of renal disease in people with hypertension. Hence, it is essential to identify the link between gender and development and/or course of the diseases (if any).

Clearly, lifestyles will be another important variable to measure as numerous research suggest that certain lifestyle positively affects peoples health. However, it is unclear whether shaping the lifestyle can slow down development of renal disease in patients with hypertension. Therefore, it is essential to trace the changes (if any) in health conditions (blood pressure and the rate of renal function impairment) while shaping patients lifestyles.

Finally, it is crucial to measure benefits (if any) of medication self-management in patients. The patients should have particular medication treatment and they have to provide certain reports. This will ensure proper monitoring of the treatment as well as benefits of self-management.

Reference List

Buffet, L., & Ricchetti, C. (2012). Chronic kidney disease and hypertension. US Pharmacist. Web.

Jones, L.M. (2014). Reducing disparities in hypertension among African American women through understanding information seeking and information use (Doctoral thesis, The University of Michigan). Web.

Kauric-Klein, Z. (2012a). Blood pressure knowledge in hypertensive hemodialysis patients. The CANNT Journal, 22(4), 18-25.

Kauric-Klein, Z. (2012b). Improving blood pressure control in end stage renal disease through a supportive educative nursing intervention. Nephrology Nursing Journal, 39(3), 217-228.

Abstract

Sexually transmitted infections account for high numbers of deaths and infections among the youth. A safe sex campaign can be an important initiative to reduce sexually transmitted infections. This essay discusses unprotected sex among teenagers as a public health issue that promulgates the spread of STDs. A large number of sexually active youths are engaging in unsafe sex and contributing to the rates of the newly reported STD cases. However, a safe sex campaign may suffer from social stigmatization. Therefore, the public health campaigners must use culturally sensitive materials and ethical approaches.

Introduction

Sexually Transmitted Diseases (STDs) pose challenges to the global healthcare systems. According to Jemmott, Jemmott, Fong, and Morales (2010), millions of youths engage in unprotected sex because they are unaware about the devastating effects of STDs. The global statistics of STDs reveal that youths of 15 to 24 years account for the largest number of the individuals that present new cases of STDs (Chinsembu, 2009). STD campaigns are vital, but often challenging. This essay examines an STD public-health campaign against unprotected sex.

An STD Public Health Concern (Unprotected Sex)

A growing concern among the health care practitioners is the increasing cases of STDs that associate with unprotected sex. Most youths are reckless in dealing with their premarital affairs, especially the sexual issues (Saewyc, Barney, Clark, & Brunanski, 2013). Youths are sexually active and they often engage in numerous sexual affairs. In the United States, over 6% of the high school youngsters engage in sexual intercourse while below 15 years, while 34% of the university students practice anal, vaginal, and oral sex (Jemmott et al., 2010).

Why Unprotected Sex Needs a Public Health Concern

STDs are sexually transmitted infections that spread through sexual contact. Unsafe sex often spreads deadly sexual infections (Chinsembu, 2009). An increase in the number of youths with STDs is distressing for the healthcare systems and for the entire nation of the United States. According to Jemmott et al. (2010), although the American youths with ages that range from15-24 contribute to only 25% of the sexually dynamic population, this age group accounts for almost a half of the emerging STD cases, with a high transmission rate of 72%.

A Potential Challenge in the Campaign

STDs are normally embarrassing infections among the citizens. Very few STD victims feel free to take tests or engage in public STD campaigns (Saewyc et al., 2013). This is because they fear to disclose their health statuses. Hence, the youth-campaign concerning safe sex may face a problem of social stigmatization. Youths are very cautious about disclosing their health statuses to their colleagues, family or to the health counsellors (Samkange-Zeeb, Spallek, & Zeeb, 2011). In this campaign, youths may fear to pass safe sex information or attend the campaign.

Ways to Address the Campaign Challenge

A health campaign on sensitive and ethically challenging issues like safe sex practices often requires effective marketing approaches and an understanding of the public relations and principles (Maibach, Abroms, Marosits, 2007). The campaigners will develop culturally sensitive campaign materials and use the most ethical campaign techniques. The campaign team will encourage the formation of community partnerships among the youths, who understand each other well, encourage social friendliness among the youths, and use friendly and youthful speeches to attract the youths.

Conclusion

Poor sexual behaviours such as unprotected sexual intercourses often predispose the youth to deadly STDs. A public health campaign about safe sex practices among the youths can be an effective way to reduce the spread and severity of the STDs. Setting a public health campaign about a sensitive and an ethically challenging issue, such as unprotected sex and its contribution to STDs, requires competence in the campaign marketing. Using culturally sensitive materials and ethical approaches such as appropriate speeches may assist to reduce nonattendance and stigmatization among the victims.

References

Chinsembu, K. (2009). Sexually Transmitted Infections in Adolescents. The Open Infectious Diseases Journal, 3(1), 107-117.

Jemmott, J., Jemmott, L., Fong, G., & Morales, K. (2010). Effectiveness of an HIV/STD Risk-Reduction Intervention for Adolescents When Implemented by Community-Based Organizations: A Cluster-Randomized Controlled Trial. American Journal of Public Health, 100(4), 720-726.

Maibach, E., Abroms, C., & Marosits, M. (2007). Communication and marketing as tools to cultivate the publics health: a proposed people and places framework. BMC Public Health, 7(88), 1-15.

Saewyc, E., Barney, L., Clark, T., & Brunanski, D. (2013). Enacted Stigma and HIV Risk Behaviours among Sexual Minority Indigenous Youth in Canada, New Zealand, and the United States. A Journal of Aboriginal and Indigenous Community Health, 11(3), 411-420.

Samkange-Zeeb, F., & Spallek, L., & Zeeb, J. (2011). Awareness and knowledge of sexually transmitted diseases (STDs) among school-going adolescents in Europe: a systematic review of published literature. BMC Public Health, 11(2), 7-27.

Summary of literature review

The above review of literature shows that chronic diabetic kidney disease can be managed using the antagonistic protein agents with the potential to inhibit the action of growth factors and cytokines. These factors, which include cytokines, putative growth factors, growth hormone and insulin-like factors, play a significant role in the development and progress of the kidney problem in diabetic individuals. The specific proteins are designed specifically to allow them to identify, target and bind to the active sites of these factors in order to inhibit their actions.

Health promotion theory

The health promotion model designed and proposed by Nola Pender is one of the most effective nursing approaches in promoting health among communities. The model states that every individual has a set of unique characteristics as well as experiences with impacts on the subsequent actions (Pender, Murdaugh & Parsons, 2012).

For instance, the variables for behavioral specific knowledge have significant impacts on human motivation (Peterson & Bredow, 2011). The expected outcomes include improved state of health, enhancement of an individuals functional abilities and improved quality of life at all the stages of human development (Sitzman & Eichelberger, 2012).

The nurse and clinicians should consider the sub-concepts of the model such as personal, biological and psychological factors of the patients. In this way, it is possible to promote health in individuals with diabetic kidney disease. The nurses will be required to consider a number of factors when implementing care. For example, the degree of self-esteem, perceived health status, body mass, agility and balance will be important in developing the appropriate health interventions.

Intervention method

Promoting health among for the patients with diabetic kidney disease will involve a wide approach that includes an analysis of the clinical, dietary, psychological and personal factors. In this case, the patients will be required to continue undergoing the appropriate medical therapies, including the use of proteins that are antagonistic to the identified biomedical factors (Stewart, 2013). However, there will be an emphasis on the dietary intake in order to ensure that the amount of proteins and fluids consumed do not promote the development of the kidney problems. In addition, the diabetic condition must be managed using the right diet in order to maintain the right glucose levels in the body.

Plan for interventions

An interdisciplinary group of nurses and clinical experts will be involved in providing these services in order to ensure that all the factors identified in the health promotion model are considered. Registered nurses (RN) will determine the personal, psychological and other factors that affect each patient.

The nurses will record these factors and forward them to the other members of the interdisciplinary group. The group will debate and derive some effective ideas and decisions for the right intervention method. Clinicians will be expected to lead the clinical approach, while RN nurses will conduct the psychological and personal approach. In addition, the RN nurses will be responsible for the follow up. The audience will include the patients and their families.

Summary

The intervention is appropriate because it considers a wide range of factors that affect the patient. Apart from the clinical symptoms and drug therapy, several factors such as psychological, physical and personal matters affect the patients. These affect the outcomes of the interventions. By considering these factors, the probability of obtaining the desired outcomes in health promotion is likely to be high.

References

Pender, N. J., Murdaugh, C. N., & Parsons, M. A. (2012). Health Promotion in Nursing Practice. Washington, DC: Pearson Education.

Peterson, S. J., & Bredow, T. S. (2011). Middle Range Theories: Application to Nursing Research. New York: Lippincott Williams & Wilkins.

Sitzman, K., & Eichelberger, L. W. (2012). Understanding the work of nurse theorists: A Creative Beginning. New York: Jones & Bartlett.

Stewart, M. (2013). Prolific Policy: Implications for Advanced Practice Registered Nurses. Health Policy and Advanced Practice Nursing: Impact and Implications, 1(2), 213-218.

Introduction

This paper studies infectious disease trends and nurses role in epidemiology. It defines the commonly used terms and discusses how caregivers can reduce contaminations. The report features three current diseases caused by hepatitis A, Vibrio, and Salmonella viruses, and analyzes how Healthy People 2020 initiative addresses them. Finally, it suggests strategies for managing infectious diseases based on the example of sexually transmitted diseases (STDs) prevention and treatment. The paper proves that infectious diseases are an acute problem but their effects and outbreaks can be eliminated.

The Role of Nursing in Epidemiology

Epidemiology is a branch of medicine that studies the incidence of diseases, the methods of their distribution, and the determinants of individuals health. To understand how nursing is connected with epidemiology, it is necessary to address the terminology the discipline uses. The following definitions were suggested by the World Health Organization. An outbreak is an unexpected increase in the number of cases of infection. Incidence refers to the number of newly diagnosed cases within a defined period in a specified population. Prevalence can be determined as a proportion of individuals being infected at a certain point in time (World Health Organization, 2016). The presented terms are core for epidemiology.

Nurses role in epidemiology should not be underestimated. According to Altin and Stock (2015), nurses can provide patients with information about infectious diseases, identify their risk factors, inform them about the available methods of prevention. Caregivers can also study recent outbreaks to assess the risks for the local population. It is necessary to point out that caregivers are usually the first people with whom individuals discuss their concerns. Therefore, nurses role in assessment, diagnosing, and providing psychological support is crucial.

Current Infectious Diseases Evaluation

According to the report made by the Centers for Disease Control and Prevention, recent infectious diseases in the US include hepatitis A, Vibrio parahaemolyticus, and Salmonella contaminations. Hepatitis A has occurred in 2017 among individuals using injection and non-injection drugs, as well as homeless people and their close contacts. The most affected states are Arkansas, California, Indiana, Kentucky, Michigan, Missouri, Michigan, Ohio, Tennessee, Utah, and West Virginia (Centers for Disease Control and Prevention, 2017). The symptoms include fever, headache, and malaise, but the diagnosis should be confirmed by blood testing.

The outbreak of Vibrio parahaemolyticus (2018) was caused by the consumption of fresh crab meat from Venezuela. Currently, there are 12 people infected with the virus (Centers for Disease Control and Prevention, 2018). The affected states include Maryland, Louisiana, Pennsylvania, and the District of Columbia. The report shows that it takes two to four weeks to become infected, which means that more illnesses might be reported later. The symptoms of vibriosis typically include diarrhea, abdominal pain, nausea, and vomiting.

The outbreak of Salmonella in 2018 was associated with the consumption of pre-cut melon. It has affected around 70 people with a median age of 67, more than 50% of them were hospitalized (Centers for Disease Control and Prevention, 2018). The most affected states are Indiana, Michigan, and Missouri. The symptoms can include sudden bloody diarrhea, abdominal pain, fever, and nausea.

Healthy People 2020 Objectives

Two of the mentioned cases of infections are associated with Healthy People 2020 objectives considering food safety. One of the goals of the initiative is to reduce diseases caused by the Salmonella species that are commonly transmitted through food. Healthy People programs target is to minimize the cases of contamination down to 11,4 per 100,000 population (The Office of Disease Prevention and Health Promotion, 2018). It is notable that the number of infections has been declining since 2010. The initiative also plans to diminish the cases of illnesses caused by Vibrio species down to 0,2 per 100,000 (The Office of Disease Prevention and Health Promotion, 2018). Healthy People aims to cover hepatitis A vaccine among children of 19 to 35 months as well as reduce the disease to 0,3 new cases per 100,000 (The Office of Disease Prevention and Health Promotion, 2018).

Strategies for Reducing Infectious Diseases

It is necessary to analyze evidence-based practices used for reducing infectious diseases to learn how medical professionals can prevent or treat them. For example, in the case of sexually transmitted diseases, there are five strategies nurses can follow to control the spread of infections (Workowski & Bolan, 2015). It is necessary to accurately assess the risks of individuals contamination and provide them with information about the ways to avoid the diseases. Those methods include the use of contraception while having sexual contacts and changes in sexual behavior, for example, limiting the number of sexual partners. For vaccine-preventable STDs, pre-exposure vaccination of individuals can be utilized to reduce the risk. It is also necessary to consider both typical and atypical symptoms while diagnosing sexually-transmitted diseases; conducting additional testing is crucial. Finally, a medical professional should provide treatment and counseling not only to infected individuals but their sexual partners as well. A similar strategy can be applied to reduce other infectious diseases.

Conclusion

It is necessary to mention that infectious diseases are preventable and care providers can make a significant contribution to reduce them. Nurses play a crucial role in contamination prevention, as they can be the sources of information for patients. Recent outbreaks of infectious diseases, including hepatitis A, Salmonella, and Vibrio infections prove that the issue has to be addressed and controlled. Healthy People 2020 aims to reduce the cases of contamination. However, it is the medical professionals responsibility to implement strategies for the infectious diseases elimination.

References

Altin, S., & Stock, S. (2015). Health literate health care organizations and their role in future health care. Journal of Nursing and Care, 4, 1-3.

The Office of Disease Prevention and Health Promotion. (2018). Food safety. Objectives. Web.

The Office of Disease Prevention and Health Promotion. (2018). Immunization and infectious diseases. Objectives. Web.

Centers for Disease Control and Prevention. (2018). Multistate outbreak of Salmonella Adelaide infections linked to pre-cut melon. Web.

Centers for Disease Control and Prevention. (2018). Multistate outbreak of Vibrio parahaemolyticus infections linked to fresh crab meat imported from Venezuela. Web.

Centers for Disease Control and Prevention. (2017). Outbreaks of hepatitis A in multiple states among people who use drugs and/or people who are homeless. Web.

Workowski, K. A., & Bolan, G. A. (2015). Sexually transmitted diseases treatment guidelines, 2015. Morbidity and Mortality Weekly Report. Recommendations and Reports, 64(RR3), 1-137.

World Health Organization. (2016). WHO malaria terminology. Web.