Studies have shown that human beings are susceptible to mad cow disease, as a large number of Britons has been confirmed to carry the human form of the disease (Falco par.1). This implies that in every 2,000 people, one person has the protein that is associated with the disease. From these statistics, 30,000 Britons carry the protein. However, research has not revealed the number of carriers that are likely to develop the disease. Creutzfeldt-Jakob is the scientific and medical name used to refer to the human form of mad cow disease (Falco par.2).
Creutzfeldt-Jakob disease is a disorder that damages the brain. It is caused by consuming meat that is contaminated by mad cow disease. The protein that codes for this disease in humans is known as prion protein (PrP) (Falco par.4). There is high likelihood that many people will develop the disease at some point in their life. The incubation period of the disease is not yet known although scientists estimate it to be approximately 8 years.
The results of the research study were obtained from an analysis of 32,441 appendixes. The researchers tested them for the abnormal prion protein. The protein was found in only 16 samples (Falco par.4). This equated to one case in every 2,000 people. Currently, only 177 cases of the disease have been reported in Britain. However, millions of people could be carriers of the disease.The research gave estimates based on the number samples that tested positive.
The estimated number of carriers may be erroneous because of the technological limitations of methods used to analyze the samples. In addition, researchers are not certain how long it takes to detect prions (Falco par.6). This implies that more people might be carriers of the disease only that prions have not yet reached the detection stage. Genetic profiling carried out by researchers on the samples revealed that more Britons could be carriers.
Two types of variations on the gene that codes for the causative proteins exist. These are VV variation and MM variation (Falco par.7). Four samples that tested positive were obtained from individuals with VV variation. Research indicates that only 15% of Britons have this type of variation. On the other hand, four samples that tested positive came from people with MM variation. Research indicates that approximately 45% of Britons have this type of variation (Falco par.9). The relationship between the protein and these variations has not yet been clearly established. However, all the reported cases of the disease involved people with MM variation. Researchers have suggested an incubation period of eight years. Therefore, it might take long before detection of more cases of the disease (Falco par.9).
Works Cited
Falco, Miriam. 30,000 May Carry Human Form of Mad Cow. 2013. Web.
Interstitial lung disease refers to various chronic disorders that affect the heart. It causes damage to tissues of the lungs, inflammation of air sacs, and can lead to permanent scars on air sac tissues. Such scars cause stiffness of the lungs in the long run.
According to researchers, there is a high prevalence of lung diseases among people diagnosed with dermatomyositis (DM) and polymyositis (PM). It is contrary to the belief that people who suffer from DM and PM are not exposed to lung diseases. Interstitial lung disease can be detected in good time before typical symptoms become evident when physicians use pulmonary function tests and other computerized procedures.
Studies have shown that patients of DM and PM are exposed to almost similar risks, and the condition is hardly related to inclusion-body myositis. Besides, researchers have found out that amyopathic dermatomyositis patients are susceptible to lung diseases.
Medical professionals can determine the chances of myositis patients getting interstitial lung disease. For instance, patients who possess anti-Jo1 antibodies are perceived to be more likely to develop interstitial lung disease. Their risk percentage is believed to reach a high of 70 percent. Besides, their likelihood of getting a fever, mechanics hands, and arthritis are high.
It is important to detect interstitial lung disease early enough before the symptoms become more pronounced. This makes it possible for the application of treatment procedures that reduce the chances of the disease turning chronic. When interstitial lung disease reaches the chronic stage, it is referred to as chronic pulmonary fibrosis. Treatment is usually a complicated procedure and is determined by the type of patient (Interstitial Lung Disease, 2012).
Blurred Vision
Blurred vision, which is also called blurry vision, refers to the inability to see sharply. It may occur gradually or suddenly to one eye or in some cases, to both eyes. Blurred vision sometimes comes as a symptom of other conditions, diseases, or disorders that might start mildly and become serious later. It is caused by slight problems like wearing the wrong eyeglasses and nearsightedness. However, it can also be caused by trauma, inflammation, malignancy, infection, and other processes that are not normal. This requires individuals to discuss slight vision problems with relevant doctors.
Some slight vision problems can cause blindness as it happens with eye injuries. In some serious cases, death may occur when there is bleeding in the brain, and emergency medical measures are not taken. The blurred vision should not be taken for granted even when it appears to be temporary because it can lead to other complications such as hypertension, epilepsy, and stroke.
Blurred vision can start suddenly and go away within a short duration of time. This may for example happen when one tries to refocus on something that is far after being overexposed to the sun or after reading. It may also occur in form of sudden and severe episodes like the ones that result from head trauma. Slowly developing a blurred vision that portrays other symptoms may indicate the onset of cataracts. Any vision changes should be given the attention they deserve by visiting medical professionals because blurred vision may be the beginning of serious and deadly disorders (Blurred Vision, 2013).
Although hospitals offer an environment that is conducive for recovery from illnesses, it is unfortunate that there is a likelihood of contracting some diseases and infections from the settings. A hospital-acquired disease is a type of illness that a person can get in a healthcare environment, for instance, hospitals, nursing homes, or rehabilitation institutions (Khan, Ahmad, & Mehboob, 2015). These types of diseases are also referred to as nosocomial infections. Since the diseases can also be contracted in the course of health service delivery outside a clinical facility, they are sometimes known as healthcare-associated infections. Infection control and management of pathogens responsible for hospital-acquired diseases are vital since they are a threat to the lives of health professionals, patients, and visitors.
Blackwell (2015) describes a situation where a Canadian woman had gone to a health care facility for a regular hysterectomy and the removal of an ovary but later succumbed to a belly infection that had advanced to necrotizing fasciitis. She developed the infection after her surgical wound acquired pathogens in the course of her stay in the hospital. It was reported that this was a single case out of 8000 deaths, which occurred in Canada as a result of hospital-acquired infections. Moreover, in the late 2000s, a hospital in Quebec and two in Toronto announced that they had discovered that contaminated sinks were mainly responsible for hospital-acquired infection outbreaks in the regions.
National Healthcare Safety Network with the Center for Disease Control (CDC) considers meningitis, gastroenteritis, and infections affecting the urinary tract, surgical/soft tissues, and respiratory system as the most common hospital-acquired illnesses. Nosocomial infections occur as a result of various microbes, of which bacteria account for approximately 90% of all cases of the infections in healthcare settings; protozoans, fungi, and viruses are responsible for the rest of the percentage (Khan et al., 2015). The nosocomial infections causing pathogens can be transmitted from one individual to another either directly through physical contact or indirectly through surfaces, items, and substances that are contaminated. Hospital staff, patients, and people visiting the health facilities are highly vulnerable to the development of hospital-acquired illnesses. Since every medical staff is supposed to be in regular contact or interaction with patients, they are likely to get the infections if the patients that they attend have ailments that can be transmitted from one person to another. Health professionals can acquire infections from patients having pulmonary diseases, needle prick communicable illnesses, or transmissible skin diseases. Additionally, the workers can pick the pathogens responsible for the infections from contaminated medical equipment, surfaces, or air droplets if they do not apply proper hygiene practices. Visitors who come to see patients in health care facilities can also contract the infections if they have skin-to-skin contact with infected patients or when they touch or hold contaminated items and surfaces.
All patients admitted or visiting healthcare facilities are also susceptible to hospital-acquired infections, especially elderly patients, those with defective immunity, and the extremely young, such as premature babies. When a medical staff fails to observe proper hygiene, he or she can transmit nosocomial infections from contaminated surfaces, equipment, or themselves to the patients (Khan et al., 2015). The sick people can also contract the infections by coming into direct contact with the skin of a person with any of the infections or contaminated air, surface, and items such as bedding, doors, sink handles, among others. Sometimes the microorganisms responsible for some of the infections can originate from the skin microbiota of a patient after a surgical operation or any other procedure, which interferes with the protective barrier of the body skin. Although the infection forms occur as a result of patients skin conditions, they are still considered hospital-acquired since they develop in a healthcare environment. In conclusion, the clinical setting should be the safest place for the well-being of all; patients, visitors, and health professionals. Infection control practices by healthcare personnel can have a considerable impact on the reduction of diseases and deaths.
References
Blackwell, T. (2015, January 19) Infected and undocumented: Thousands of Canadians dying from hospital-acquired bugs. National Post. Web.
Khan, H. A., Ahmad, A., & Mehboob, R. (2015). Nosocomial infections and their control strategies. Asian Pacific Journal of Tropical Biomedicine, 5(7), 509-514.
We rarely think of the risks and consequences of acute disease, until we face it. Our bodies often warn us of an upcoming challenge, but we ignore these signs. Hypothermia is an acute health diagnosis that does not happen at once but can have devastating impacts on all human organs and systems. I could not imagine that I would ever be admitted to a hospital with hypothermia. Now I keep suffering from the damaging consequences of my mistakes because it is always better to prevent a disease than to deal with its complications.
Living before contracting the disease
I am a 79-year-old man. My wife died two years ago. Since then, I have been trying to find my way in life. Before Eleanor died, she had always cared for me. I never thought I had to cook, clean, or use the laundry machine. Everything in my life was organized. Eleanor knew that I had to care for my health. She made regular appointments with my physician and knew how I felt. She monitored how I took medicines and made sure I never missed a visit to the hospital. After her death two years ago, I could hardly understand how I would survive. Drinking became a daily routine for me. I forgot about proper nutrition and ate, whatever I could find in the nearest store. Within months, I lost nearly 20 pounds, but my emotional grief left little room for physical suffering. I simply did not notice that the tragedy was coming. Last winter, I nearly froze myself to death, as I could not find my way home. I was drunk. By the time I reached home, my hands and legs were pale, and I started to feel sleepy. This winter, the situation has been much worse: on my way to the food store, I got lost in a snowstorm. I was hungry and drunk, and it is alcohol and hunger that favored the rapid onset of hypothermia.
I must say that, as an elderly person, I face higher risks of hypothermia than my younger counterparts. According to Cire, older people are at risk for hypothermia because their bodys response to cold can be diminished by certain illnesses such as diabetes and some medicines, including over-the-counter cold remedies. Moreover, elderly peoples bodies do not generate enough heat to withstand extreme colds (Cire). I ignored all precautions and did not think about hypothermia. I had a few clothes on me at the time of the snowstorm. I did not wear any gloves or hats. On the same day, I was admitted to the hospital. Estimating the exact number of such patients does not seem possible, mainly because emergency departments register only the severest cases (Edelstein & Adler). Still, the rates of mortality in hypothermic patients are quite high: between 12% and 40% of patients with moderate and severe hypothermia are likely to die (Edelstein & Adler). These rates are similar for men and women, but the youngest and the oldest ones are particularly susceptible to these risks (Edelstein & Adler).
I should say, that my age was not the only risk factor for hypothermia. Certainly, age matters, because older people may not be able to communicate or move when they are cold (Mayo Clinic). However, I was also drunk, and alcohol is one of the most prevalent factors of hypothermia and poor metabolism (Mayo Clinic). Alcohol leads to the dilation of blood vessels; as a result, the body loses heat faster (Mayo Clinic). Being drunk, I was mostly indifferent as to what I was wearing, where I was going, and what could happen to me. Poor nutrition further contributed to the development of hypothermia: before the snowstorm, I had not eaten for several days, and this is actually why I left home and went to the food store.
As I said earlier, hypothermia does not happen at once. Now I can remember how I was getting cold on my way to the food store. At first, I felt how my hands, feet, and head were getting cold. My face was swelling and I could feel my skin going pale. I cannot remember whether I was shivering, but I started to feel sleepy. I did not care, because I attributed my state to alcohol and hunger. In a couple of hours, I was not able to move. I was not able to speak. I sat down in the snow because I could not walk any longer. For some reason, I decided I had to wait until the snowstorm was over. My heart was getting slower. Then, I could not remember anything, until I opened my eyes in the emergency department.
Establishing the diagnosis
I was admitted to the nearest emergency department with the following symptoms: shivering, clumsy speech, poor movements, poor decision-making and confusion, slow breathing, and weak pulse (Mayo Clinic). I was also half-conscious. I felt as if my energy had left me (Mayo Clinic). I was not quite aware of what was happening to me. Mayo Clinic suggests that individuals with hypothermia may not realize the severity of their condition, because the symptoms emerge gradually, leaving individuals in confusion. This is, probably, what happened to me, because even now I cannot remember the details of my being admitted to the hospital.
What I know is that I had to undergo all possible tests and diagnostic procedures to confirm the diagnosis. Although the circumstances of my admission made the diagnosis absolutely evident, my body temperature was measured. The nurse used a rectal thermometer, which showed 28oC (82.4oF) a boundary condition between moderate and severe hypothermia (McCullough & Arora 2327). I should say that, in a normal condition, my temperature would have to range between 36.0 and 36.6oC (97.8oF). The ECG showed a decreased heart rate. Ventricular arrhythmias were also noted. A blood test for alcohol was made, and the blood alcohol concentration (BAC) was estimated at 0.10. Normally, such tests would show no alcohol. I do not think they measured any potassium or electrolyte levels, because the symptoms of hypothermia were too obvious. At times, patients with hypothermia may display the signs of coagulopathy, but I am not sure I had it (McCullough & Arora 2328). What they said was that I had a metabolic disorder, which made me extremely vulnerable to the risks of hypothermia. They told me I had a decreased basal metabolic rate, which could have its roots in thyroid dysfunction (McCullough & Arora 2327).
Fig.1. Safe cardiac arrest time against temperature (Walpoth et al. 391).
The pathophysiology of hypothermia is quite straightforward. Hypothermia is a state that affects all organs and systems: the flow of blood becomes slow, and cells no longer have enough energy to maintain their normal function. Because hemoglobin binds more oxygen at lower temperatures, all organs and systems may suffer from hypoxia. I lost most heat through radiation, convection, and conduction, coupled with respiration and active evaporation. Due to the loss of heat and low temperature, my hypothalamus could not maintain adequate levels of heat production and conservation (Edelstein & Adler). The CNS and cardiovascular system suffered the most: the cardiac output and arterial pressure kept decreasing and could lead to myocardial ischemia or sepsis (Edelstein & Adler). Low temperatures led to decreased CNS metabolism, further reducing brain activity. Every time body temperature falls by 1oC, cerebral metabolism decreases up to 10% (Polderman S187). Oxygen consumption by tissues also continued to decrease (Edelstein & Adler). Not surprisingly, I could not manage my actions and thoughts any longer. The level of consciousness was abnormally low. I was simply dying.
Treatment and prognosis
At first, the nurse removed my clothes, and I was placed under warm blankets. I was given thiamine because it has minimal adverse effects on patients with a history of alcohol abuse (McCullough & Arora 2329). Active external rewarming was used to speed up and increase body temperature. My skin was normal, and they used heating pads and hot water bottles to help me recover from the cold. A warm IV saline solution was used to warm my blood (Mayo Clinic). The intravenous solution was continuously warmed with a fluid heater to raise my body temperature through induction (Tsuei & Kearney 10). Induction is the best way to transfer heat (Tsuei & Kearney 10). Now I know that warm saline fluid is an essential element of hypothermia treatment.
As a result of hypothermia, I also developed pancreatitis and aspiration pneumonia. However, pancreatitis can also be attributed to the nutrition problems I had been facing before hospitalization. I had to spend almost one month in the hospital. Luckily, I was not admitted to intensive care. I was also lucky to avoid the most common sequelae usually left after hypothermia treatment, including renal failure and aftershock. Today, I have to monitor my nutrition and heart rate, while keeping warm and avoiding any alcohol. I have to test the levels of electrolytes regularly to prevent the risks of delayed renal failure. I believe that, due to my age and health status, the long-term consequences of hypothermia will continue to persist. I do not think I can fully recover from what happened to me, but I am happy to be alive and conscious.
Conclusion
Hypothermia is a serious health condition, which affects all organs and systems. The consequences of hypothermia can vary considerably, from milder complications to death. Hypothermia is easy to prevent, but the sequel of hypothermia treatment is likely to persist with age. An individual who once suffered from hypothermia will have to constantly monitor changes in his (her) physical health.
Works Cited
Cire, Barbara. Hypothermia: A Cold Weather Risk for Older People. NIH News, 2009. Web.
Edelstein, Jamie and Jonathan Adler. Hypothermia. Medscape, 2011. Web.
Mayo Clinic. Hypothermia. Mayo Clinic, 2011. Web.
McCullough, Lynne and Sanjay Arora. Diagnosis and Treatment of Hypothermia. American Family Physician, 70.12 (2004): 2325-2332. Print.
Polderman, Kees H. Mechanisms of Action, Physiological Effects, and Complications of Hypothermia. Critical Care Medicine, 37.7 (2009): S186- S202. Print.
Tsuei, Betty J. And Paul A. Kearney. Hypothermia in the Trauma Patient. Injury, 35.1 (2004): 7-15. Print.
Walpoth, B.H., T. Locher, F. Leupi, P. Schupbach, W. Muhlemann & U. Althaus.
Accidental Deep Hypothermia with Cardiopulmonary ArrestL Extracorporeal Blood Rewarming in 11 Patients. European Journal of Cardio-Thoracic Surgery, 4.7 (1990): 390-393. Print.
Disease outbreaks occur when infected individuals are allowed to mingle with healthy ones or if their contents get in contact and this means that quarantines are the best ways of managing these epidemics. Canada experienced a serious epidemic in 1952 when the foot and mouth disease broke out in a Saskatchewan firm and spread to the nearby counties. This condition took too long before it was controlled due to failure by various individuals to take corrective measures to manage it. The events that followed led to a $977,600 expenses that involved funds for compensating farmers and eradication campaigns. This led to the formation of a commission that interviewed various stakeholders in the ministry of agriculture to investigate what happened that led to the indiscriminate spread of the foot and mouth disease.
Analysis
Foot and mouth is a deadly disease that kills domestic and wild animals if they are not given immediate attention. Even though, Canada had fought this infecting a long time ago it has developed measures that ensure all animals and their products are properly tested to ascertain their health conditions. These include testing all animal [products entering Canada or moving from one firm to another and also testing their qualities before being processed for human consumption. the ministry of agriculture has research and testing departments that ensure emergencies are attended to without delays. However, this case study shows that none of the officers in charge of disease prevention took proper and timely steps to avert the spread of the epidemic.
First, when Mr. Charles Blair noticed that his animals had blisters on their tongues, were not eating, and reduced their milk production he contacted the local veterinary department. The Indian Head veterinarian gave a prescription by telephone and did not outline precautionary measures. Even though he was on leave he should not have prescribed drugs for animals he had not examined. This shows irresponsibility and negligence and the wise thing to do would have been to contact his colleague and refer the matter to him. Also, the farmer did not request to know what he was supposed to do to avoid the spread of the disease to other animals and firms and that is why he invited his two neighbors to help. Later, their animals were also infected because the disease spread from Mr. Blairs animals to theirs due to lack of preventive measures and this led to quarantine.
Moreover, Dr. R. Thompson, the Veterinary Director in Regina showed complexity by allowing his staff to do what they wanted. He did not make follow-ups to ensure that standard procedures were observed. Dr. Campbell did a good work of traveling to the firm and conducting a diagnosis of sick animals. Also, he reported the issue to Ottawa the same day he suspected the animals were suffering from vesicular stomatitis. However, he lifted the quarantine without informing his boss or conducting extensive research to establish the truth about the disease. Besides, the Rhodes packing plant that was located in the nearby farm did not diagnose its animals before they were bought for slaughter. It is easy to blame almost everybody involved in contributing to the disease outbreak due to the roles they played in delaying diagnosis or failing to communicate on time.
Dr. P. Bailey held a powerful position in disease prevention and animal health promotion did not take this issue seriously. He was quick to dismiss claims that the disease was foot and mouth without even conducting research or waiting for laboratory results to prove his opinion. Also, the Committee of the House of Commons had a general agreement that nobody should use the term foot and mouth disease because it had serious implications. Therefore, the fear of making people hysterical made the department reluctant to conduct research and establish the truth about the epidemic. Besides, Canada suffered the last disease outbreak (foot and mouth) in the 1890s and this was a perfect resume for the ministry of agriculture to feign ignorance about the disease.
Also, it took too long before any communication was made from Regina to Ottawa. This means that the field officers sent there did not do their work as required. There were reluctance and laziness in the manner in which they conducted their affair and this gave the disease time to spread to other farms. Mr. Davies did not play his part well by failing to request for information from Dr. Knight regarding the position on the ground. Moreover, he did not take any action even after being informed that the disease had spread to other areas and the measures being taken were not helping to alleviate the situation. Dr. Saunders failed to communicate in time regarding the disease and this created room for laxity in the ministry.
Another unique event, in this case, was the role played by Dr. Bailey when the animal specimens were sent to Hull. The ministry acted unprofessionally by allowing its staff to do business on its behalf even when they were on leave. It is shocking that Dr. Bailey countermanded the order and claimed that it was not safe to do so. The case shows that even though Dr. Blair was on statutory leave he was still working and controlling the activities of the ministry. There seem to be no proper communication channels between the main office at Ottawa and their grass root branches. Dr. Saunders should not have allowed the specimens to be moved to Ottawa because there were laboratories in Regina that could perform the same functions as the main one.
Mr. B. Davies, The minister of agriculture seems not to know who is responsible for failing to play their roles in disease prevention. During the committee hearings, he was not sure who should answer which question and always had a person in mind that was well suited to answer specific questions. However, when that individual took to the stand the minister became adamant and uncomfortable when explaining the roles of his staff in disease prevention. Besides, he did not know the early quarantines and only knew about them when the situation had worsened. Therefore, there is the need to priorities events in this ministry to ensure that even though the minister may not be informed about every happening on the ground the most important ones should hit his desk. There is a need to ensure that all diseases are given serious attention to avoid the occurrence of another epidemic. The staff of this ministry must start working and follow standard procedures to ensure they perform their roles properly.
Chronic Obstructive Pulmonary Disease (COPD) (ICD 10 J44.9) is the primary diagnosis for L. J. A partial restriction of airflow in the airways occurs in this disease with alveolar damage. It can happen because of an inflammatory response to toxicity. In addition, it frequently evolves due to smoking. According to statistics, it is one of the conditions causing death (Amstrong, 2012). More than 6% of the American population dies because of it. The highest prevalence is among Caucasian population. The symptoms of this disease include coughing with sputum and shortness of breath. Often enough patients have whistling in the chest. The patient has signs of COPD. The person coughs with characteristic sputum. The history of smoking is present. Apart from that, the tests revealed +prolonged expiratory phase. The flattening of the diaphragm has been observed. Lab tests evidence moderate airway obstruction.
Secondary Diagnosis
Tobacco Dependence (ICD 10 F17.2) is the secondary diagnosis. This condition is one of the main reasons for morbidity and mortality. It can lead to the development of Chronic Obstructive Pulmonary Disease and certain form of cancer (for instance, lung cancer). It has a tendency to affect airflow and the entire respiratory tract (Amstrong, 2012). Individuals suffering from tobacco dependence have a lower capacity to exercise and, in general, have a poorer health status. L. J. has a long history of smoking. The patient smokes approximately 65 packs yearly, which has resulted in other negative manifestations as well. For example, coughing intensifies when L. J. intends to be physically active.
Additional/Tertiary Differential Diagnoses
Anxiety disorder (ICD 10 F41.9) is the first differential diagnosis. Patients suffering from COPD tend to develop this condition rather often. The evidence suggests that up to 50% of senior patients experience it (Kennedy-Malone, Fletcher, & Plank, 2014). Anxiety disorder has a potential to intensify the symptoms of the main disease; therefore, it is essential to evaluate L.J.s cognitive well-being. Many individuals suffer from this disorder because of their fear to work out. It can strongly affect pulmonary rehabilitation, and such patients should receive pharmacological interventions to take control of their health state (Wahls, 2012).
Hypertension (ICD 10 I10) is the next diagnosis. It is a disease associated with recurrent or persistent high blood pressure. Both systolic and diastolic indicators are important for this matter. When it comes to the patient, smoking can be one of the factors that can cause hypertension (Benich & Carek, 2011). In addition, patients age and weight pose additional threats to the development of ischemic heart disease. The person receives Lisinopril to manage blood pressure; nevertheless, patients with COPD are rather likely to have arterial stiffness.
Hypercholesterolemia (ICD 10- E78.0) is the last diagnosis. At present, the patient takes Simvastatin every day, which evidences the presence of this condition. L.J. requires additional assistance regarding hyperlipidemia management; therefore, they should be informed about the need for behavior modification (King, Kingery, & Casey, 2012). L. J. should exercise enough, keep a balanced diet, and get enough rest. Since the patients body mass index is more than 27, they will relieve the symptoms of the current disease by leading a healthier lifestyle. Moreover, other COPD-associated conditions will become less intense.
Plan
The plan of treatment should include both pharmacological and non-pharmacological interventions. L. J. should quit smoking and lead a healthier lifestyle. To manage COPD, long-acting anticholinergic therapy can be advised. However, beta2 agonist can be prescribed as well. Apart from that, inhaled maintenance drugs can also help in alleviating the consequences of this condition (Lee, Kim, & Tagmazyan, 2013). L. J. can be prescribed Aclidinium (400mcg) to relieve wheezing and other respiratory issues (one dose of oral inhalation 2 times per day). Importantly, the drug can cause AV block and heart failure (Lee et al., 2013).
References
Amstrong, C. (2012). ACP updates guidelines on diagnosis and management of stable COPD. American Family Physician, 85(2), 204-205.
Benich, T.J., & Carek, P. J. (2011). Evaluation of the patient with chronic cough. American Family Physician, 84(8), 887-892.
Kennedy-Malone, L., Fletcher, K., & Plank, L. (2014). Advanced practice nursing in the care of older adults. Philadelphia, PA: F. A. Davis Company.
King, M., Kingery, J., & Casey, B. (2012). Diagnosis and evaluation of heart failure. American Family Physician, 85(12), 1161-1168.
Lee, H., Kim, J., & Tagmazyan, K. (2013). Treatment of stable chronic obstructive pulmonary disease: The GOLD guidelines. American Family Physician, 88(10), 655-663.
Wahls, S. A. (2012). Causes and evaluation of chronic dyspnea. American Family Physician, 86(2), 173-180.
Topic: The topic of the teaching work plan proposal hereof is Prevention of Sexually Transmitted Diseases in Miami, Florida.
Table 1. Planning Before Teaching.
Name and credentials of the teacher:
Estimated time teaching will last: approximately 2 periods; each session will take 60 minutes
Location of teaching: Miami Senior High School
Supplies, material, equipment needed: a PC or a laptop, a projector and an overhead screen, educational videos; paper, pencils, pens, and index cards
Estimated cost: approximately $100-120.
Community and target aggregate: high-school students
Topic: Prevention of Sexually Transmitted Diseases (STDs)
Epidemiological Rationale for Topic: 46% of teenagers in the US have their first sexual intercourse in high school, 39% of which do not use condoms. In Miami, Florida, the rates STD rates have doubled since 2007 (Trepka et al. 2017).
Nursing Diagnosis: The risks are aggravated by the lack of awareness of STD prevention methods, which necessitates educational interventions.
Readiness for Learning: Students readiness for learning is reflected in their expression of sexually related feelings towards the opposite sex and their interest in the body image.
Learning Theory: The Social Development Theory is to be utilized for the project. It states that consciousness, cognition, and development are preceded by social interaction (Daniels, 2016). Since the target population consists of teenagers, the influence of their peers cannot be neglected.
Goal: One of the key objectives is number HIV-2: Reduce the number of new HIV infections among adolescents and adults ( Healthy people 2020, 2017). Since the number of the affected is on the rise in Miami, preventive teaching is required.
Relation to Alma Atas Health for All: Alma Atas Global initiatives address prevention and control of STDs (including HIV/AIDS) as well as the aforementioned objectives.
Table 2. Objectives, Content, Strategies:
Behavioral Objective and Domain
Content
Strategies/Methods
1. Students will be able to understand how STDs are transmitted (cognitive).
1. STDs are transmitted through sexual intercourse with the carrier of the infection.
1. Presentation via a simulated transmission (a role play). Students will take roles and build transmission chains from one to another.
2. Students will be able to list the most widespread STD, their signs and symptoms (cognitive).
2. STD types (Chlamydia, syphilis, HIV/AIDS, etc.), methods of acquisition (sex, drugs), treatment, and prevention (abstinence, safe sex).
2. Lecture followed by an interactive game. Students will be divided into teams and make questions based on the lecture.
3. Students will be able to define abstinence and list refusal skills (cognitive).
3. Abstinence is avoidance and sexual contact preventing STDs.
3. Say no exercise. Students will practice using verbal and non-verbal means of refusal.
4. Students will learn to use contraception (behavioral).
4. The proper way of using pills and condoms will be discussed.
4. Video and discussion. Students will watch a video on contraception use and discuss it.
Creativity: Visual effects, interactive games, and videos will be used.
Planned Evaluation of Objectives:
usefulness of transmission simulation (questionnaire);
students background on the topic (pre- and post-tests);
abstinence lessons learned (discussion);
contraception awareness (pre- and post-tests).
Planned Evaluation of Goal: STD statistics will be assessed at the end of the school year. The school nurse will be interviewed.
Planned Evaluation of Lesson and Teacher: An anonymous evaluation questionnaire will be used.
Barriers:
embarrassment (handled by establishing the trust);
disrupting students (to be removed);
difficult materials (to be adjusted to become comprehensible).
Communication: To hook students in, I will demonstrate the theory of six handshakes, drawing a parallel with STDs. The presentation will end up with a summary and discussion.
Community Presentation
Teaching Experience
Summary of the Teaching Plan
After conducting a thorough assessment of the community needs of Miami, the topic of prevention of Sexually Transmitted Diseases (STDs) was selected as one of the most pressing for the local population. It was found out that the community lacks both educational and health promotion measures, especially in schools. The number of STDs in adolescents is rapidly growing, which necessitates changes that would allow increasing their awareness on the topic. That is why Miami Senior High School was chosen as a perfect location for the project since high-school students demonstrate the highest interest in the topic of sexual relationships and the lowest knowledge of possible dangers.
The teaching will require 2 sessions, approximately an hour each (with a break in-between). To attract the attention of the audience, the presenter will start with a demonstrative game, asking each student (since the audience united several classes) to shake hands with those whom they know best. After that, the theory of six handshakes will be presented to the students to show that although they shook hands with only 3-4 people, they actually touched everyone in the class. This introductory game is intended to draw a parallel with the mechanism of STD transmission. This demonstration will be supported by a brief fact sheet covering the STD statistics in Miami.
To establish trust, the lecturer will resort to life examples and encourage students to ask questions and take part in the discussion (since they will likely feel embarrassed and ill at ease). To increase their understanding of the material presented, it will be adapted to be comprehensible for their linguistic and scientific levels. Moreover, several tests and questionnaires will be used for the students to check what knowledge they have on the topic. Videos and interactive games will be utilized to evoke interest.
At the end of the lecture, the key points will be summed up with the help of the students. The major goal of the educator will be to estimate whether the lecture managed to increase their awareness of the issue and encouraged them to use means of contraception. The necessity of screenings for STDs will also be discussed.
Epidemiological Rationale for Topic
Teenagers all over the United States tend to engage in risky sexual behaviors much more often during the last decade. 46% have their first sexual intercourse in high school, 39% of which do not use condoms. This problem is particularly acute in Miami, Florida, where rates STD rates have doubled since 2007 (Trepka et al. 2017).
This problem is exacerbated by the fact that the trend goes unnoticed by the authorities. Thus, no prevention programs are launched to increase awareness of STDs, their prevention, diagnosis, and treatment. Moreover, the majority of schools in Miami do not have sex education as a part of the curriculum (although an innovative prevention education program has already been adopted) (Oster et al. 2014). Another risk factor is the teenage culture that encourages a higher frequency of sexual intercourse with different (or even unfamiliar) partners who can easily be found via phone-dating apps.
At the same time, the situation becomes worrying indeed since there are more than 400 cases of Chlamydia and 20 cases of syphilis, and over 40 cases of HIV/AIDS per 100,000 residents. As a result, Miami is considered to be the countrys number tw0 HIV spots (the status that it has earned since 2009, reaching the peak in 2011). The majority of STDs are curable but can cause serious fertility problems if they are not treated in due time. Syphilis may also lead to rashes and paralysis (Workowski & Bolan, 2015).
The necessity to address the problem at the school level is supported by the fact that younger people are more likely to be infected (more than 56% of all cases) and less likely to be timely diagnosed (Liu et al., 2015). This is partially explained by their unwillingness to use condoms and to undergo a medical examination, especially if there are no visible symptoms (as is often the case with silent diseases ). Besides, the majority of teenagers do not know that they can be tested for STDs without having their parents notified.
Evaluation of Teaching Experience
Even though is it always challenging to communicate with adolescents on such delicate subjects, the experience turned out to be positive and rewarding. The knowledge obtained in the course of the lecture and discussion can be used for future community projects. Communication techniques are also applicable for other population groups.
Although surprising it may seem, all the participants arrived at least 10-15 minutes before the beginning of the lecture and greeted each other in a friendly manner, and showed genuine interest in the topic (although some of them still felt embarrassed). On the whole, it was evident that they were mentally and emotionally prepared for the discussion to come and even demonstrated concentration and diligence when it came to memorizing scientific facts. Many of them asked questions and interacted with one another. Several disruptive students made rude jokes and interrupted the lecture; however, there was no need to remove them since their peers opposed this inadequate behavior.
As expected, the students were more interested in visuals and interactive games rather than in statistics and lengthy explanations. They encouraged each other to take part in role-playing and enjoyed the activity. However, it must be admitted that the prevailing majority of the participants also completed the questionnaires offered to them to check what they have learned. While the students felt at a loss being asked to do the same tests before the lecture and did not show good results, their scores at the end of it were much higher. The lecturer also received positive feedback on the way the whole event was organized and performed.
Some of the participants also asked for handouts to study at home and came up to the lecturer to specify information about medical screenings. Others wanted to share their problems and ask for a piece of advice, which indicated that a due level of trust was established with the audience.
Community Response to Teaching
Although it is early to judge whether the educational intervention described above was successful, it is still evident that the response of the community was positive. As has already been mentioned, many participants demonstrated a genuine interest in the issue and came up to the lecturer for further clarification. Many of them wanted to copy the video to watch it at home. The results of the tests and questionnaires offered to the students revealed that they managed to significantly enhance their knowledge of STDs, their signs, symptoms, and prevention methods. Furthermore, leaving the classroom, many students expressed their willingness to take part in other discussions and lectures if they are to take place.
The school principal remained satisfied with the results of the project and suggested redesigning the lecture so that it could be utilized for the education of younger students. A possibility to elaborate the complete course of sexual education for students was also discussed. Finally, it was decided to organize a support office for teenagers to come for consultations.
The participants parents also expressed their gratitude to the author of the project. It was suggested to repeat the experience in other educational institutions including universities. After a profound discussion with social workers and other community members, the decision was made to create a website for adolescents to inform them on the topic and provide anonymous support.
Areas of Strengths and Areas for Improvement
As it is evident from the report above, there were numerous areas of strengths. First and foremost, the communication between the education and the students was based on trust and mutual respect. This type of interaction is difficult to establish with representatives of this age group. Another positive aspect was connected with the effective use of all the provided materials. The video and the lecture were informative while interactive role-playing was entertaining and motivating. The tests developed by the lecturer acted as effective assessment tools of the students understanding of the subject.
A few areas of weaknesses can also be identified. For instance, the initial meeting with the school principal should have taken place earlier to avoid problems connected with the preparations. Then, providing an advertisement for the event would have attracted more students.
References
Daniels, H. (2016). Vygotsky and pedagogy. London, UK: Routledge.
Healthy people 2020. (2020). Web.
Liu, G., Hariri, S., Bradley, H., Gottlieb, S. L., Leichliter, J. S., & Markowitz, L. E. (2015). Trends and patterns of sexual behaviors among adolescents and adults aged 14 to 59 years, United States. Sexually transmitted diseases, 42(1), 20-26.
Oster, A. M., Sternberg, M., Nebenzahl, S., Broz, D., Xu, F., Hariri, S.,& Paz-Bailey, G. (2014). Prevalence of HIV, sexually transmitted infections, and viral hepatitis by urbanicity, among men who have sex with men, injection drug users, and heterosexuals in the United States. Sexually Transmitted Diseases, 41(4), 272-279.
Trepka, M. J., Mukherjee, S., Beck-Sague, C., Maddox, L. M., Fennie, K. P., Sheehan, D. M.,& Lieb, S. (2017). Missed opportunities for preventing perinatal transmission of Human Immunodeficiency Virus, Florida, 2007-2014. Southern Medical Journal, 110(2), 116-128.
Workowski, K. A., & Bolan, G. A. (2015). Sexually transmitted diseases treatment guidelines. Reproductive Endocrinology, 2(24), 51-56.
Infectious diseases pose a significant burden and negative impact on many nations, including Haiti. In Latin America, the three major causes of death that have been singled out are respiratory diseases, diarrhea, and vaccine-preventable diseases (VPDs) (Ulloa-Gutierrez et al. 1671). It is an unfortunate situation, given that some of these conditions have been almost brought under control by use of vaccines in some parts of the world. Vaccination, by definition, is an attempt to use part or all of a microbial pathogen to protect against that microbe (Plotkin and Plotkin 890). Similarly, a vaccine is a part or whole of a microbial pathogen used in the immunization process (Plotkin and Plotkin 890).
This paper discusses the history of vaccines as one of the approaches to prevent diseases. The objective is to reflect and contemplate personal experiences with vaccines and their influence on my perceptions and future interaction with them. In addition, ideas, concepts, social concerns, and issues associated with vaccines use, i.e., human values that influence the guardians decisions to vaccinate their children are discussed. In particular, the paper also singles out the dynamics of vaccine coverage, acceptance, and refusal, courtesy of changes in human attitudes and values. From the above objectives, the extent to which these parameters impact the success of a vaccination program and the overall health of the population will be quantified.
The History of Vaccines
Vaccination is thought to have originated from the homeopathic viewpoints about small doses of disease, enabling the body to withstand severe disease (Plotkin and Plotkin 891). By the eleventh century, there were clues in the Chinese manuscripts of the use of variola scabs inhaled into the nose to immunize against smallpox (Plotkin and Plotkin 891). Literary evidence shows that the practice then spread to India, the Middle East, Africa, and Europe (Plotkin and Plotkin 892). Nevertheless, the origin of vaccines as an endeavor date later in the 1700s from the works of the farmer Benjamin Jesty and Doctor Edward Jenner on the appearances of milkmaids that demonstrated the capacity of cowpox to protect people from the devastations of smallpox (Plotkin and Plotkin 892). Jesty injected his family with the materials from the poxvirus wounds, but Jenner carried out clinical trials and published his findings to the scientific community (Plotkin and Plotkin 892). The use of the poxvirus to fight smallpox was adopted globally, and it led to the eradication of the disease (Plotkin and Plotkin 892).
Additional progress was made eight decades later in the laboratories of Louis Pasteur when he discovered the procedure of attenuation using Pasteurella multocida, the causative agent for chicken cholera (Plotkin and Plotkin 892). He realized that he could weaken the virulence of a bacterium by exposure to harsh conditions and proceeded to work on anthrax and rabies vaccines. At the dawn of the nineteenth century, vaccine development started to have a justification. The main milestones were procedures to inactivate whole bacteria, which could then be used as vaccines, the discovery of bacterial toxins, the production of antitoxins and the realization that immune serum contained antibodies that counteracted toxins or bacterial replication (Plotkin and Plotkin 893). For instance, inactivated whole-cell vaccines against typhoid, cholera, and plague were produced and tested. It was also demonstrated that diphtheria bacilli produced an exotoxin and that an antitoxin was elicited in the sera of animals that had received sublethal doses of that toxin (Plotkin and Plotkin 893). The finding heralded the beginning of the use of toxoids as vaccines.
Currently, purification of pathogenic elements, genetic manipulations and improved knowledge of immune protection allow direct creation of attenuated mutants, cloning of vaccine proteins in live vectors, purification and even synthesis of microbial antigens, and induction of various immunological responses through manipulation of various biomolecules (Plotkin and Plotkin 893). These approaches to vaccine development have enabled the pharmaceutical industry to produce a wide variety of vaccines.
Examples of Vaccines
Presently, many diseases can be prevented by immunization. Both communicable and non-communicable ailments are presently within the spectrum of vaccinology, and the vaccines so far developed have accomplished significant reductions in infections and disease worldwide. Some of conventional vaccines include the BCG and hepatitis B vaccines that are administered at birth and diphtheria, tetanus, pertussis, measles, mumps, rubella, and polio vaccines that are given severally in a childs early life (Kroner 7). In 2013, World Health Organization (WHO), the Centers for Disease Control (CDC), and the GAVI Alliance supported the introduction of the five-in-one vaccine.
This pentavalent immunogen helped shield Haitian children against diphtheria, hepatitis B, whooping cough, pneumonia, and meningitis (Kroner 7). The intervention also entailed training doctors, providing vaccines at affordable prices, and ensuring appropriate distribution. Such vaccination programs are a social investment since their introduction and proper implementation and monitoring results in an increase in life expectancy. For example, the single-dose regimen of hepatitis A universal immunization program that was initiated in 2005 in Argentina for children 12 months old reduced the incidences of hospitalizations, acute liver failure, deaths, and liver transplants (Ulloa-Gutierrez et al. 1672).
Personal Experience
Two worlds exist for the Haitian children regarding vaccine equity: those who can access new vaccines and those who have poor access due to economic limitations. I happen to come from a family, which was not endowed economically, and there were no funds for the doctors. Therefore, I could not access all the necessary vaccines. When new vaccines are brought to the market, they come at an exorbitant price. Such vaccines are usually available in the private sector and afforded by a few. Later, when such vaccines are availed at a reduced cost, it takes a lot of communication and social mobilization to stir the interest of the parents in the vaccines.
Flexible state laws regarding vaccination of children make parents careless and fail to immunize their children; my parents could not allow me to be vaccinated because it was not mandated. Their hesitance to immunize me probably was influenced by issues of confidence, the inability to see the need and value for a vaccine and access to the vaccine provision. The complacency might also have stemmed from the surrounding communitys low priority accorded to the vaccines, under-appreciation of the need for vaccination or lack of knowledge. Traditionally, Haitians have been falsely blamed for acting as carriers of infectious diseases like HIV/AIDS and tuberculosis. Thus, testing, research, and health care provisions, mainly from the USA were met with mistrust, apprehension, and caution.
Another reason might have been the tendency to rely on home remedies. In a society which lacks accurate knowledge about vaccines, beliefs that other therapies (traditional medicine or naturopathy, religious authorities, breastfeeding) are equally or even more important than vaccination in controlling VPDs and maintaining health make people hesitant to embrace vaccines (Sadique et al. 1671). Superstitions on vaccines such as vaccines infecting one with the very diseases they are meant to cure, that VPDs are required to build immunity, and those vaccines destroy crucial natural resistance or that supernatural forces cause some of the VPDs contribute to vaccine hesitancy (Sadique et al. 1671).
Social Concerns
Despite the benefits of vaccine introduction in national immunization programs, below-average vaccine coverage rates are frequently recorded in ethnic minorities. The subtleties of vaccine acceptance and use are complicated and depend on both social factors and cultural perceptions (Burghouts et al. 2). These include opinions on vaccinations and diseases, perceptions of vulnerability and protection, and the function of medicines in producing and maintaining health. Burghouts et al documented the fear of side effects, perceived limited vaccine tolerance by toddlers and sick children, and experiential concept that side effects of vaccines are diseases as some of the reasons for refusing vaccination (3).
The triumph of a vaccination program is incumbent upon high numbers of approval and coverage. Unfortunately, there is evidence of escalated cases of vaccine rejection and of regional crowding of refusals which result in outbreaks (Omer et al. 1987). A decline in the occurrence of a VPD mostly makes people think that the gravity of the infection and the vulnerability thereof has reduced. The complacency reduces the urgency to seek immunization services. Likewise, the awareness of real and alleged adverse effects associated with vaccines has increased, resulting in many people refusing vaccines. Statistical evidence supports the observation that there is the tendency for geographical clustering of incidences of vaccine acceptance or refusal (Omer et al. 1988).
The reasons for this trend are unknown, but it is speculated that the characteristics of the local population -socioeconomic status, income, cultural issues, and awareness and beliefs of local health practitioners, opinion leaders, and local media coverage are factors that play a role (Omer et al. 1988). Community leaders, politicians, the clergy, and celebrities can have a profound impact on vaccine acceptance and refusal. On the same note, the media and social media create constructive or destructive sentiments among people and provide the podium for lobby groups and opinion leaders to influence the society (Omer et al. 1988).
Recent parental concerns about purported vaccine safety issues have led to an increasing number of parents refusing or delaying to vaccinate their children. Children who do not comply with school immunization demands are at risk of suffering pertussis and measles and can communicate a disease to others yet to be vaccinated due to age, medical reasons, or insufficient body immunity (Omer et al. 1988). In a state where the school immunization policy is adequate, the number of children that are exempt from this requirement for health unrelated reasons serves as the primary parameter to quantify vaccine rejection in a population.
Concerns are on the rise about the probable link between vaccines and disorders such as autism, attention deficit syndrome, learning disabilities, juvenile diabetes, autoimmune diseases, asthma, and sudden infant death syndrome (Kroner 7). Vaccines contain a mixed blend of chemicals, microbes and other foreign matter. These ingredients are of three categories: the bug material (live or killed viruses or bacteria, nucleic acids or toxoids), preservatives, and adjuvants (kroner 8). Some of the preservatives and adjuvants used may include Ethylene glycol, Aluminium, Gelatin, Benzethonium chloride, Formaldehyde, Glutamate, Neomycin, Phenol, Streptomycin, and Thimerosal (Kroner 8).
In addition, cultures of human fetal tissue, chicken embryos, guinea pig embryo cells, and bovine serum are used (Kroner 8). Despite the fact that these materials have been permitted by the US Food and Drug Administration (FDA), many people have found them to be controversial and have reservations due to fear that they can be harmful to the body (Kroner 8). What is more, these substances trigger common and even adverse reactions associated with vaccines. The common side effects include fever, swelling, pain, crying, vomiting, diarrhea, anorexia, sleepiness, aches, and rash while serious side effects include Guillain-Barre Syndrome, encephalitis, seizure disorders, and sub-acute sclerosing panencephalitis, among others (Kroner 9).
Concerns that vaccines might cause autism rose from three hypotheses (Plotkin and Plotkin 892). First, there was fear that a blend of measles-mumps-rubella (MMR) vaccine causes autism by irritating the gastrointestinal membrane, causing the permeation of encephalopathic proteins into the body. Second, it was believed that the thimerosal, an alkyl mercury-containing preservative in some vaccines, causes an insult to the central nervous system (Plotkin and Plotkin 892). Thirdly, researchers held that concurrent administration of several vaccines overpowers or weakens the immune system (Plotkin and Plotkin 892).
Furthermore, controversy arises from procedural aspects of childhood vaccinations like the number of shots a child should receive by a certain age. Worldwide, there is a debate that the escalated diagnosed cases of developmental disabilities and learning disorders are directly proportional to the excessive shot regimen recommended by world health bodies (Kroner 9). In the USA, for instance, the number of vaccines received by children rose from 10 in the 1970s to 18 vaccines in the 1990s to the current 24 vaccines (Kroner 9). The vaccine schedule is more complex nowadays, and children are subjected to far more shots than before (Kroner 9).
Occasionally, parents refuse these vaccines or postpone immunization of their babies by following novel timetables proposed by GPs (in place of those formulated by multidisciplinary expert committees) for convenience and safety concerns (Kroner 9). Refusal to vaccinate children puts such children at a higher risk of acquiring and transmitting VPDs. In cases of spatial aggregation of individuals not immunized, VPD clusters are also expected to be documented. The risk of VPDs and the consequences of such diseases change as the child grows. Since infants are at a higher risk of illness, disability and death related to communicable diseases, vaccine delays have resulted in severe repercussions.
In contemporary Haiti, fortified policy interventions, e.g., the need to immunize children before they are admitted in schools have caused an improvement in vaccine coverage thus playing an essential part in decreasing or eliminating widespread transmission of several diseases. Meningococcal disease caused by Meningococcus bacteria is a contagious disease, which most frequently affects teens and young adults (Omer et al. 1986). It is best protected by vaccination using the MenACWY and MenB vaccines. It is now a state requirement that people in these age brackets are immunized against the disease.
Conclusion
The history of vaccines and their contents have been particularized. The arguments surrounding childhood vaccination and its role in influencing parental decisions have been assessed. As it has been shown above, there are many reasons for and against vaccination. Therefore, concerned parents need to be enlightened, so that they make informed choices regarding their childrens health. Maintenance of the huge benefits that vaccines have brought to the society call for concerted efforts to enhance public awareness and confidence in the vaccine monitoring and quality assurance system.
Works Cited
Burghouts, Jochem, et al. Childhood Vaccine Acceptance and Refusal among Warao Amerindian Caregivers in Venezuela; A Qualitative Approach. PLoS ONE, vol. 12, no. 1, 2017, pp. 1-14.
Kroner, Shannon. Childhood Vaccinations: The Development of an Educational Manual. Dissertation, The Chicago School of Professional Psychology, 2013. UMI, 2013.
Omer, Saad, et al. Vaccine Refusal, Mandatory Immunization, and the Risks of Vaccine-Preventable Diseases. The New England Journal of Medicine, vol. 360, no. 19, 2009, pp. 1981-1988.
Plotkin, Stanley, and Suzan L. Plotkin. The Development of Vaccines: How the Past Led to the Future. Nature Reviews/Microbiology, vol. 9, no. 1, 2011, pp. 889-893.
Sadique, Zia, et al. The Effect of Perceived Risks on the Demand for Vaccination: Results from a Discrete Choice Experiment. PLoS ONE, vol. 8, no. 2, 2013, pp. 1-9.
Ulloa-Gutierrez, Rolando, et al. Vaccine-Preventable Diseases and their Impact on Latin American Children. Expert Review of Vaccines, vol. 10, no. 12, 2011, pp. 1671-1673.
Influenza has occurred in different subtypes since 1918 in Swine. Human influenza viruses exist in several types with continuous and fast evolutionary changes, the capability of widespread, and short incubation periods (Brown, 2000).
The chain of infection of H1N1 influenza is hard to break because it is transmitted through the respiratory system and contact. When an individual is infected, he coughs and sneezes. As a result, anybody within one meter from the infected person is likely to be infected. Furthermore, if an inspected person touches his mouth or nostril while blowing his nose, the virus collected by the hand can find its way to another person after shaking of hand (Luckhaupt et al. 2012). Anybody who shakes hands with an infected person and does not wash his hands thoroughly is at risk of infection. The infection chain can continue until serious interventions are put in place.
Influenza has several pathogens seen when one is infected. The type depends on the host species. When a human being is infected with the H1N1 virus, is mainly due to the influenza A virus. These pathogens adapt to the human environment. The antibodies in the human body cross-react with the H1N1 virus but do not protect.
Influenza infects a large variety of animal species. These animals include pigs, horses, birds, sea mammals, and several wild animals (Brown, 2000). It is also known that aquatic birds are the main source of these viruses for other species.
Influenza is transmitted between human beings mainly through respiration. However, human beings who come in contact with infected pigs are infected. Human beings are known to infect pigs with the influenza virus too. It is also possible for turkeys and ducks to transmit this virus to human beings (Brown, 2000).
Pigs have served the role of intermediate host for reassortment of influenza A viruses of avian and human origin (Brown, 2000). This is because it is the only mammalian animal that is reared in large numbers and susceptible to the virus.
Various public health measures are used to mitigate the effects of influenza on human beings. Epidemiological surveillance has been used in three different systems. Clinical surveillance, virological surveillance, and serological surveillance are commonly carried out. The main role of epidemiological surveillance is to detect a virus early enough so that preventive and control measures are put in place.
Quarantine of infected persons is essential to avoid infecting uninfected ones. People being protected from infection through quarantines are family members, visitors, health care workers, and colleagues. If correctly implemented, quarantine can help to stop the spreading of influenza (Gostin, 2006).
The role of immunization in controlling the spread of influenza is to prevent uninfected people from infection even if they contact infected ones. Immunization plays an important role in protecting people who are not infected with the contagious influenza virus.
Prophylaxis plays an important role in preventing healthcare workers and healthcare providers who are attending to sick people from infection. When one suspects that he has been exposed to an infection, he can use Prophylaxis to minimize chances of infection (Gostin, 2006).
Public health regulations proposed to the public by health experts have a big role in controlling the spread of influenza. If a case of infection is reported in a village or town, regulations imposed on the area can prevent possible spread to other areas. Screening and mandatory medical examinations at airports prevent the spreading of influenza to other cities, states, and countries. International public health regulation helps to establish communication between countries about the epidemic (Katz, 2009).
Generally, several measures which are mentioned have key roles in mitigating the effects of H1N1 influenza both locally and internationally.
References
Brown, I.H. (2000). The epidemiology and evolution of influenza viruses in pigs, Veterinary Microbiology, 74. 29-46.
Gostin, L.O. (2006). Public Health Strategies for Pandemic Influenza: Ethics and the Law. Journal of the American Medical Association, 295(14), 17001704.
Luckhaupt, S.E., Sweeney, M.H., Funk, R., Calvert, G.M., Nowell, M., DMello, T., Reingold, A., Meek, J., Yousey-Hindes, K., Arnold, K.E., Ryan, P., Lynfi eld, R., Morin, C., Baumbach, J., Zansky, S. Bennett, N.M., Thomas, A., Schaffner, W., and Jones, J. (2012). Influenza-associated Hospitalizations by Industry, 200910 Influenza Season, United States. Emerging Infectious Diseases, 18(4). Web.
Felson, D. T. et al. (2000). Osteoarthritis: new insights. Ann Intern Med, 133(8), 635-646.
The article by Felson and colleagues (2000) is the first of two summaries of a conference on osteoarthritis disease and its risk factors organized by the National Institutes of Health. The main focus of the article is to provide a better understanding of osteoarthritis, along with the associated risk factors. The authors note that osteoarthritis is the leading form of arthritis among adults above the age of 30 years in the United States. Felson et al. (2000) further note that with the increase in the number of baby boomers, the prevalence of osteoarthritis is expected to grow further. They have also noted a correlation between age and osteoarthritis, and that sex-specific differences also tend to be quite evident. Symptoms and pathology are two of the leading criteria for defining osteoarthritis by the authors.
The authors have further examined the relationship between hormonal status and bone density in postmenopausal women, suggesting that an estrogen deficiency is crucial in the development of the disease. Felson et al. (2000) have also examined the nutritional factors that may cause osteoarthritis, including persistent exposure to oxidants. On the other hand, a high dietary intake of micronutrient antioxidants is thought to prevent the development of osteoarthritis.
The authors also note that genetic factors are responsible for nearly 50 % of osteoarthritis of the hips, hands, and knees. Local biochemical factors such as obesity, sports participation, joint deformity, muscle weakness, occupational factors, and acute joint injury have all been noted to play a crucial role in the causations of osteoarthritis.
Felson et al. (2000) suggest that dealing with or preventing the onset of osteoarthritis through lifestyle changes can play a crucial role in preventing many clinical problems associated with musculoskeletal disability. The article is useful in not only helping to shed light on the cause and risk factors of osteoarthritis but also in providing suggestions on how to delay or prevent the disease.
Giles, W., & Klippel, J. H. (2010). A National Public Health Agenda for Osteoarthritis. Web.
In this article published by the Center for Disease Control (CDC), Giles and Klippel (2010) explore osteoarthritis, terming it as the most common form of arthritis in the United States. The authors also note that osteoarthritis places a severe limit on the quality of life and daily activities of more than 27 million Americans. They further note that osteoarthritis mainly affects knees, hips, and hands, resulting in disability, weakness, and affects work productivity as well. Osteoarthritis generates socioeconomic costs as well, such as in joint replacement. Moreover, Giles and Klippel (2010) note that the increased cases of obesity among an aging U.S. population will lead to a dramatic increase in the prevalence, economic consequences, and health impact of osteoarthritis.
Based on the foregoing arguments, the authors contend that there is a need to take bold and innovative action to minimize the burden of osteoarthritis. As such, the article is a platform for a focused and collaborative initiative aimed at providing evidence-based intervention strategies, creating communicative initiatives, supportive policies, and strategic alliances to prevent and manage osteoarthritis, as well as facilitating research for a better understanding of the condition. Towards this end, the authors have provided valuable recommendations that need to be adopted to ensure the achievement of these strategies. First, there is a need for self-management education for osteoarthritis patients. There is also the need to promote physical exercise at the community level.
In addition, the authors argue that existing interventions and policies capable of reducing osteoarthritis-related injuries ought to be implemented, enforced, and promoted. Finally, Giles and Klippel (2010) recommend that weight management ought to be promoted as a preventive and treatment strategy for osteoarthritis. This is a useful publication that not only explores the disease burden of osteoarthritis but also provides useful suggestions on how to manage it.
Brandt, K. D. (2010). Diagnosis and nonsurgical management of osteoarthritis. New York: Professional Communicator Inc.
In this book, Brandt (2010) has provided an authoritative view on osteoarthritis, with the main focus on its practical aspects. In defining osteoarthritis, Brandt stresses that it is one among several overlapping distinct diseases with various causes but similar morphological, biological, and clinical outcomes. In his definition of osteoarthritis, Brandt stresses the articular cartilage. The books chapter on the pathogenesis of osteoarthritis helps to shed light on the shift from cartilage to bone. The author has noted the crucial role of radiography in the diagnosis of osteoarthritis.
In addition, Brandt has explored several pitfalls that normally accompany the diagnosis of osteoarthritides, such as the misinterpretation of laboratory tests and the radiograph. Brandt has also devoted several chapters of the book to exploring the non-surgical treatment of osteoarthritis. For example, he has dwelt at length on NSAIDs that inhibit COX-2. Other non-surgical treatments that the author has explored include capsaicin cream and rubefacients. He does not hide his optimism in the treatment of osteoarthritis using injection with steroids, although he is a bit skeptical about the use of hyaluronic acid injections in treating knee osteoarthritis.
Brandt has provided a lot of practical information in his book, perhaps because the book is mainly meant for primary care physicians. On the other hand, most parts of the discussion are meant for such specialists as arthritis health professionals and orthopedic surgeons.
The book is both useful and informative because it provides detailed information on the epidemiology, pathology, and clinical features of osteoarthritis. In addition, it has also provided some of the pitfalls that normally accompany the diagnosis.
Gilkeson, G. (Producer). & Austin. L. (Presenter). (2012). Osteoarthritis: an overview. [Podcast]. South Carolina: Medical University of South Carolina. Web.
In this podcast, Gilkeson and Austin (2011) begin by defining the disease. In this case, Gilkeson defines osteoarthritis as a disease of the joint that occurs when the cartilage of the bone has worn out. Gilkeson also contends that immune reactivity and inflammation may also be involved in the development of osteoarthritis. He further notes that the prevalence of the condition increases with age. Genetics also plays a part in the development of the disease, and repetitive trauma such as that involved in sports may eventually cause early onset of osteoarthritis. Gilkeson opines that there is no documented association between long-distance running and osteoarthritis, possibly because such runners tend to be lighter in weight. As such, an increase in weight is a risk factor for the development of osteoarthritis.
Maintaining a normal healthy diet will go a long way to preventing osteoarthritis, although studies do not show any link between the taking of supplements and prevention of osteoarthritis. Gilkeson argues that losing weight, and exercising can prevent the disease which if not taken care of may become a crippling problem necessitating knee, joint or hip replacement. In terms of treatment, Gilkeson notes that nodular osteoarthritis can be treated using steroid injection, while knee osteoarthritis can be treated using highly ironic acid injection.
Reference List
Brandt, K. D. (2010). Diagnosis and nonsurgical management of osteoarthritis. New York: Professional Communicator Inc.
Felson, D. T. et al. (2000). Osteoarthritis: new insights. Ann Inter Med, 133(8), 635-646.
Giles, W., & Klippel, J. H. (2010). A National Public Health Agenda for Osteoarthritis. Web.
Gilkeson, G. (Producer). & Austin. L. (Presenter). (2012). Osteoarthritis: an overview. [Podcast]. South Carolina: Medical University of South Carolina. Web.