The National Health Service is the organization responsible for the realization of the program of continuous quality improvement in the United Kingdom. Several key issues regarding the problem can be determined nowadays. In particular, the NHS has undertaken financial reform, which influences the realization of its programs. Key elements of the delivery structure today include an emphasis on local decision-making (SteelFisher, 2005, p.2). Besides, the NHS intends to implement the changes in regulatory standards. It also makes efforts to improve the evaluation methods of healthcare services quality. The enhancement of the system of data monitoring is one of the key issues on the organizations agenda. Furthermore, the NHS recognizes the necessity of improvement of the support of primary care physicians and makes efforts in this direction.
The Quality and Outcomes Framework (QOF) is an important initiative undertaken in the United Kingdom with the purpose of the improvement of healthcare services in the country. It is based on the scoring system. However, the framework has its strengths and weaknesses. The initiative allowed creating an effective framework for the assessment of the healthcare system. Besides, it contributed to the cost-efficiency of the continuous quality improvement program. The motivation of the hospital personnel is one more advantage of QOF. At the same time, some scholars argue that the framework is not very effective in prevention methods.
Response Posts
To Ellen Ferguson
Hi, Ellen,
Very good post! I think that you have uncovered all the problems without information overload. I agree with you that the QOF indicators still need improvement, though they are really helpful for the healthcare system in the United Kingdom. Besides, you have mentioned that the transparency and independence of the indicators reviewing process require improvements. Alike you I hold the opinion that the monitoring process is not perfect nowadays. The transparency and objectivity of the QOF are the characteristics of its quality. Essentially, they are the keys to the efficiency of any project. The NHS recognizes this fact and makes efforts to improve these characteristics.
To Howard Patterson
Hello, Howard,
Very interesting opinion! As I see you have touched upon the important aspect of the National Health Care Strategy. I guess you have tried to focus our attention on the economic background of the health care problems. I also emphasize this aspect in my post. The economic downturn influences the direction of the NHS work. It should be noted that the NHS accounts for 88 percent of health expenditures (SteelFisher, 2005, p.2). This means that the economic distress puts pressure on the ability of the organization to fund its projects and the QOF, in particular. The funding should satisfy all the financial needs of health care institutions. The significant cut in spending will restrain the opportunities of hospitals to improve the quality of their services and to implement effective measures for the prevention of diseases. Also, the decrease in funding will affect all six dimensions, through which quality is expressed. Undoubtedly, such dimensions as effectiveness and efficiency will be affected the most. Overall, I should admit that we have very similar opinions. It will be great if you read my post and respond to it. It is interesting for me to know your view on my answers.
Reference
SteelFisher, G.K. (2005). International innovations in health care: quality improvements in the United Kingdom. Web.
Obtaining a Registered Professional Nurse (RN) licensure is the primary step in the transition from a student to a BSN graduate. In Illinois, the major requirement for becoming an RN is the educational background. BSN or any equivalent degree is a must for passing the National Council Licensure Examination (NCLE). With a four-year university degree, I am eligible for obtaining RN which can be considered the basic type of license in nursing.
Passing the NCLE is the second criteria for getting the RN license. It is a multiple-choice, computer-based test meant to check applicants knowledge in various areas including care environment, patient safety, health promotion, psychosocial and physiological integrity, and so on. In case a person fails the examination, he or she may use the performance report to fill the gaps in knowledge. However, it will be possible to take the NCLE again only after three months (National Council of States Board of Nursing, 2017).
Before getting a license, a nurse should provide a completed fingerprint card and criminal history record which can be obtained in any local law enforcement agency. A background free of convictions, crime history, and arrests is an important licensure criterion in Illinois. The given requirement allows the Board of Nursing to ensure greater patient safety and quality of health care.
Job Search: Chicago
Newly graduated RN at Rehabilitation Institute of Chicago (RIC)
The RN will be responsible for performing an individualized, age-specific assessment of patients, and providing nursing diagnoses to them. Candidate should demonstrate a whole range of knowledge in safety, planning, implementation of interventions, patient education and communication, and so on. To apply for the position, RNs should have the BSN or an equivalent degree, as well as a valid RN license issued by the Illinois Department of Financial & Professional Regulation. Additionally, such personal qualities as flexibility, adaptability, and critical thinking skills are welcomed by the RIC.
Dialysis nurse at Fresenius Medical Care (FMC)
The nurse will be responsible for the performance of chronic hemodialysis therapy, compliance with professional standards and FMS policies. The basic job requirements include the BSN degree and a current RN licensure. However, although new graduates are welcomed, the organization will prefer those candidates who have at least one-year experience in medical-surgical nursing, hemodialysis therapy, and ICU. Potential employees will also be required to complete a training program in hemodialysis, ICD 9 coding, and technical nursing, and successfully pass the examination. Lastly, the nurse is required to meet the Ishiharas Color Vision test requirements, i.e., should not be colorblind.
Holistic Life Balance
One-Year Plan
According to Mullen (2015), the lack of adequate work-life balance among nurses is largely predetermined by their cultural and social backgrounds, beliefs, perceptions, and knowledge which, affect individual attitudes to work and personal life. Thus, to ensure a better balance in life, during the first year, I will mainly focus on this internal outlook on the issue. Such self-care practices as relaxation, physical activities, healthy eating, and so on are essential to stress prevention and reduction. Additionally, to maintain a good work-life balance, I will evaluate the situation in my professional and personal life every two months. In this way, it will be possible to identify the areas which consume most of the energy and attention and respond to any problems promptly.
Five-Year Plan
After the first year of work, the maintenance of life-work balance may become even more important and, at the same time, challenging as the responsibilities and workloads may increase over time. Moreover, within five years, I intend to attain some goals in professional, academic, and personal development. Thus, these areas of performance should be well-balanced and integrated.
During the following five years of work, I will implement same methods as mentioned in the first plan. However, additionally, I will advocate for the managerial support of work-life balance and self-care imperatives within the hospital of my placement. Nurses ability to maintain an adequate work-life balance largely depends on organizational and staffing practices. For instance, there is a direct link between workload management, and staff members health and stress level which, in their turn, impact the quality of service and the overall patient outcomes (Van den Oetelaar, van Stel, van Rhenen, Stellato, & Grolman, 2016). Thus, advocacy for adequate work-life balance in the hospital and development of organizational policies may help to generate both individual and organizational benefits.
Stressors and Challenges
Blum (2014) distinguishes the following work-related stressors in nursing: unpredictable and challenging workspaces, increased paperwork, insufficient managerial support, role ambiguity, medical errors, staffing, care planning, etc. It is also observed that more experienced nurses are less prone to experiencing job-related stress (Blum, 2014). Thus, the implementation of coping techniques may be especially important during the first years of work.
As a method for dealing with challenges and stressors, I will engage in continual self-education, deliberate practice, and strengthening of professional relations with more experienced colleagues. Schmidt, Goldhaber-Fiebert, Ho, and McDonald (2013) state that the deliberate practice may reduce the fear of medical errors, boost nurses confidence, and help to build necessary knowledge that, in its turn, may result in a better patient safety. Thus, education and knowledge-building may be effective methods for coping with occupational stressors in nursing.
Lifelong Learning
The one-year plan will include the job-specific training and education. I also intend to get a specialty certification in Basic/Advanced Cardiac Life Support (B/ACLS) as the findings of job search revealed that employers in Chicago require it most frequently. To obtain the BCLS or ACLS certificate, I will complete a short-term course and pass the exam. The certificate will allow me to perform a greater range of responsibilities and advance in the workplace.
The five-year plan includes the completion of the doctoral degree and the pursuit of a career as an Advance Practice Nurse (APN). Advanced education and significant experience in clinical practice are the primary requirements for getting the APN license. Therefore, it will be more feasible to get it after a few years of work experience. Additionally, in the future, I would like to specialize in family medicine mainly because it integrates multiple disciplines and approaches. The given feature makes it increasingly challenging yet very appealing and interesting.
Professional Contributions
In my future career, I intend to make a contribution to medicine through the provision of high-quality care, patient education, advocacy, and research. The best way in which I will be able to contribute to the improvement of a nursing role during the first year is caring for self in the profession. Care of a nurses self and care of the profession as a whole are interrelated phenomena and, by developing one of these aspects, the nurse contributes to the development of another (Chiovitti, 2015). It means that my professional performance will reflect nursing profession as a whole and will contribute to its public image. Thus, during the first years, I will constantly be focused on self-development and improvement of skills.
As for the contribution to a nursing community during the following five years, I would like to conduct a research of a particular nursing-related health issue or organizational issue, e.g., work-life balance. The findings of my prospective study could be used in policy making, legislation, and advocacy for the improvement of healthcare which is one of the primary goals of the Nursing Community.
References
Blum, C. (2014). Practicing self-care for nurses: A nursing program initiative. The Online Journal of Issues in Nursing, 19(3), Manuscript 3. Web.
Chiovitti, R. (2015). Professionhood and professionalism as an educational aid for facilitating nursing students development and renewal of self and profession. Journal of Nursing Education and Practice, 5(11), 51-64.
Mullen, K. (2015). Barriers to work-life balance for hospital nurses. Workplace Health & Safety, 63(3), 96-99. Web.
National Council of States Board of Nursing. (2017). NCLEX examination candidate bulletin. Web.
Schmidt, E., Goldhaber-Fiebert, S. N., Ho, L. A., & McDonald, K. M. (2013). Simulation exercises as a patient safety strategy: A systematic review. Annals Internal Medicine, 158(5), 426-432.
Van den Oetelaar, W. F. J. M., van Stel, H. F., van Rhenen, W., Stellato, R. K., & Grolman, W. (2016). Balancing nurses workload in hospital wards: study protocol of developing a method to manage workload. BMJ Open, 6(11), e012148. Web.
Administrative agencies are an important part of the governmental system. They could be defined as organizations, created for solving important social problems. These agencies interact directly with people from the society and provide them required services. The Center for Disease Control and Prevention (CDC) is one of the public agencies, related to the Department of Health & Human Services. The main purpose of this agency is to protect America from health, safety and security threats, both foreign and in the U.S. ( CDC, 2014, para. 1). The agencys functions are to detect and prevent dangerous disease spreading, to apply novel technologies, and to develop healthy behavior of the community.
Main questions to the CDC:
Does the organization provide funding for the healthcare researches? What are the criteria for research program preferences?
What is the list of CDCs actions in case of emergency? What legal measures could it take?
What is the agencys policy according to the vaccination? Does it have the power to oblige parents to vaccinate their children?
Administrative agencies are important for the society due to its role in urgent social problems solving. These agencies provide their services directly to people in the community. Dealing with current problems directly, administration of the agency changes existing rules and regulations according to the particular issue to make it more efficient. Another important role of agencies is investigations and scientific researches. Agencies provide funding for research projects and apply the obtained results into the practice. However, some people believe that administrative agencies have too much power. This suggestion is based on the lack of regulation of these agencies work. In fact, administrative agencies have the power of legislation, execution, and judgment in the areas of their responsibility. It leads to the almost uncontrolled power of the administrative agencies.
Regulatory Flexibility Act
Genetic Information Nondiscrimination Act (GINA) was passed with the purpose to protect employees from the discrimination on the genetic information basis, in particular, on the basis of family diseases and inclinations. According to this act, employers have no rights to request the employees genetic information, share it among staff members or use it for the job transferring or firing. However, this act has some limitations, in particular, according to the health insurance and wellness providing.
Mainly, this act could be related to the employees individual health insurance plan development. The problem is that insurance companies are not supposed to request the information about family based diseases with the purpose to provide better healthcare services. The Regulatory Flexibility Act (RFA) could be applied in this situation to regulate the GINAs effect on these companies. In particular, some of the GINAs aspect could be avoided. For example, insurances companies might be able to request information, related to the employees health condition, however, might not be able to share it with the employer.
For example, one of the public comments (, related to the GINA, was from the company which provides wellness plans for the workers and their families. To develop the optimal plan, the company should obtain the data according to the employees genetic information, in particular, according to the metabolic diseases. After the GINA was passed, the company could not provide their services without, in fact, breaking the law. It could be stated that organizations concerns are rational. Without this particular information, it is impossible to develop the program for health improvement which would be useful. Moreover, it is possible to even to impair the situation without the required information. Thus, it could be supposed that the RFA could be applied to regulate the GINA in this particular case.
Yellow fever is an acute viral disease caused by infected mosquitoes found in tropical regions and is usually characterized by such systemic symptoms as hemorrhaging, vomiting and yellowing skin. The yellow fever is common in tropical regions, but it is important to state that it is not the same as malaria despite the fact that the two diseases have similar symptoms.
Because of these similarities, many people think that yellow fever and malaria are the same disease. This essay will highlight the causes, symptoms and effects of yellow fever while trying to explain why yellow fever is not the same as malaria.
The areas of origin of the yellow fever virus are regions of East and Central Africa. The disease was originally referred to as black vomit since the most widespread symptom was vomiting of blood.
The yellow fever disease was first reported in the 15th century, and that is when the world came to discover the fatal nature of it. The mosquito species that spread yellow fever are found in tropical climate and that is why many victims of this disease are from South America and Africa. Yellow fever is a viral disease and therefore its rate of infection is always very high compared to malaria.
The contagious nature of yellow fever made the authorities in affected areas put quarantine in place to stop further spread of the disease. The number of deaths associated with yellow fever has been brought under control by concerted efforts put in place by medical researchers who have developed various medications and vaccines. The yellow fever virus enters the hosts cells and replicates itself in form of a viral genome which later matures into an infectious virion that makes a person experience some initial symptoms.
The yellow fever virus is of the Flaviviridae family found mostly in female mosquitoes. These mosquito species act as a vector for the yellow fever virus which is transmitted to the victim through a byte. The incubation period of yellow fever is between three to six days.
The yellow fever disease has three stages which are different from each other because of the varying symptoms. The initial stage is known as the infection stage and is associated with symptoms such as vomiting, fever, loss of appetite, headache and sudden fever. These symptoms tend to disappear after three or four days.
The second stage is known as the remission stage, as all the symptoms disappear. Victims of yellow fever can recover during the second stage or the situation can get worse if the initial symptoms go beyond the first day. The third and final stage of yellow fever is referred to as the intoxication stage. At this stage, the disease starts affecting body organs. The heart, liver, and kidney are the most affected organs. Severe symptoms such as delirium, seizures and bleeding disorders are normally experienced at this stage.
There are many symptoms of the yellow fever and most of them lead to severe complications. It is advisable to seek medical attention during the infection stage to avoid severe complications experienced at the intoxication stage. Some of the severe symptoms are blood vomiting, kidney and heart failure, yellow skin, liver failure and coma. It is important to note that yellow fever is an acute disease which effects should not be underestimated.
The severe symptoms associated with yellow fever have adverse effects on the ill persons body. To begin with, symptoms, such as fever and vomiting, lead to dehydration and the situation worsens when person starts vomiting blood. During the final stage of yellow fever, vital body organs such as heart, kidney and liver may fail to function which leads to death. The treatment of heart and kidney conditions is very expensive and can therefore make the victim struggle economically.
Yellow fever has caused economic hardship and misery to those victims who are unable to afford medication. Yellow fever is a widespread disease in the third world countries because the funds meant for development projects are diverted to yellow fever treatment and prevention. The fatality rate of yellow fever is very high compared to malaria because malaria is not contagious.
The severity of yellow fever has made governments spend a lot on preventing the spread of the disease. The fact that yellow fever is a contagious disease makes its treatment even more expensive. Yellow fever has many direct and indirect effects on the lives of victims and it is therefore very important to initiate appropriate actions aimed at eradicating this disease.
In order to effectively deal with yellow fever, proper diagnosis should be done using the right methods to avoid misdiagnosis and misunderstanding. Misdiagnosis of yellow fever is a fatal error because the disease is contagious and can end up taking more lives that could have been saved through proper diagnosis of a suspected case.
Regional outbreaks of yellow fever can occur in a result of mild symptoms associated with the disease and it is therefore vital to treat suspected cases immediately. It takes six to ten days to confirm if a person has been infected with yellow fever or not. It necessary for doctors to conduct a direct clinical diagnosis that involves isolating the virus that causes yellow fever.
Indirect methods of diagnosing yellow fever are not very reliable since the yellow fever virus cross-reacts with other viruses. In order to differentiate the yellow fever virus from other viruses, special diagnosis is normally carried out. The majority of yellow fever cases are diagnosed by conducting a postmortem on a victims body.
Since yellow fever was first discovered, medical experts have come up with various forms of treatment. Vaccination is one of the main measures developed in order to prevent the spread of the disease. It has become compulsory in some regions which is a clear indication that some authorities take the disease seriously. Conventional methods of eliminating mosquitoes are also applied in order to deal with the yellow fever vector.
From early childhood, it becomes clear to every person that their time on this planet is limited, and that they will have to die one day. This realization, however, in most cases, does not manifest itself in everyday life because most people find it much more comfortable to disregard that fact and live their lives as though that moment will never come.
It can be a question for a debate as to where this attitude comes from; however, when thinking about it more thoroughly, one has to conclude that this attitude is wrong because we cannot just ignore a fact that shapes the human condition on the fundamental level.
Only when they become aware that they are ill and that there is no cure for their illness, do people accept this fact and try to spend the rest of their time in a best possible way. In recent years, in addition to the research in curative medicine, some scientists have decided that trying to find ways to eliminate the symptoms without curing the illness is worth the effort.
This branch of medicine is called hospice or palliative medicine. The aim of the people who are engaged in hospice is to establish efficient methods that could help patients who cannot be cured to spend the final days of their life in comfort by providing them with medical, psychological, spiritual and all other kinds of guidance (Methia, 2010).
First off, given the fact that the science of medicine is rapidly advancing, we are becoming able to cure more and more illnesses, it is certain that human life expectancy is going to increase. On the other hand, it is also true that a completely effective cure for deadly diseases, such as cancer, will not be found very soon.
Also, many scientists predict that in the absence of other causes, the percentage of deaths from cancer will be increasing constantly (Cancer Facts & Figures, 2012, p. 7). This places an obligation on the scientists and the society as a whole to try to find ways of improving the lives of terminally ill patients.
For the abovementioned reason, various hospice centers are being established all over the world. These centers are run either by the government within such institutions as hospitals or nursing homes, or they belong to the private sector. Each of the centers typically has a team that consists of one physician, one psychologist, one nurse and if it is religious based there is also a priest (What is Hospice Care, 2003, p. 57).
Medical help at hospice clinics has several aims. First, the chosen doctor has an obligation to explain to the patient his condition so that the patient could have an understanding of his or her situation and be able to make necessary plans accordingly. Secondly, of course, the main goal of the medical part of the team is to reduce or eliminate the symptoms of the disease. A lot of terminal diseases cause a lot of pain in terminal stages so the physician has to prescribe an adequate pain therapy.
Also, each type of condition and therapy demands a different diet so the physician has to be able to give advice or even prescribe the entire program of nutrition for a patient. In addition, if it is possible, the goal of the medical team should also be to give their best to prolong the patients life and make it as pleasant as possible. In some centers, this also includes alternative medicine such as chiropractic and many other alternative medical approaches (Gib, 2011).
It is clear that dying patients can experience psychological problems, and for that reason, almost all hospice care teams include a psychologist. The psychologist has to have specialized knowledge in the psychological conditions that are likely to occur in terminally ill patients. The main goal of this component of the therapy is to give advice and support for the patient as long as it is necessary. In addition, psychologist might also prescribe medications that can improve the patients psychological well-being (Methia, 2011).
Human beings are deeply social, and they have a strong need to be accepted in a group. Unfortunately, as it has been said, our culture still holds death as a taboo, and for that reason, people do not want to have a dying person in their environment. All of this makes a social challenge that dying people face perhaps the most difficult one.
Therefore, in addition to a psychologist, who can also be helpful in this domain, hospice teams often have a social worker whose specialty is to address this very important issue. The goal of the social worker is to take care of social aspects of the patients life. He or she has to establish good contacts with the patients family and friends.
Furthermore, if a center takes care of many people, the social worker can design activities such as group therapy in order that the patients see that they are not alone and that many people share their condition. This can be, perhaps, the most beneficial aspect of hospice, because during those activities it is not rare that the patients to make friendships, which although they are unfortunately not very long lasting, make the last days of the patients lives much happier (Methia, 2011).
These centers address one more aspect of the patients well-being which is related to economy. Today, we are living in a society where almost everything is susceptible to the market, and really necessary things tend to have huge prices. It is a sad thought that terminally ill patients are one of the groups which is the most affected by this rule. The prices of everything from special medication to the necessary medical equipment impose great economic pressure on the patients.
These centers are in most cases able to provide all the necessary services with reduced price, and they also provide many other ways to reduce the financial burden of patients and their families. The most important thing is that once a patient is received in an institution of this type, he or she can forget about all those economic difficulties and think about the things that are really important (Plocher & Metzger, 2001, p. 222).
Unfortunately, as a result of the recent economic crisis, many people are not able to provide this type of care for themselves or their loved ones. However, many government programs, like Medicare or Medicaid in the United States or similar programs in other countries of the world, are designed to cover the expenses of such care.
In the United States, people who are diagnosed with a terminal condition, and their physician made a prognosis that they have less than six months to live can choose one of a large number of licensed hospice centers and their insurance will cover the expenses (Medicare hospice benefits, 2010, p. 43).
One of the most difficult problems related to hospice is to decide when curative medicine loses its purpose, and it is time to switch to palliative medicine or hospice. Most of the people have heard of cases when a person was about to die, but they suddenly almost mysteriously recovered.
One thing should be very clear to both the doctors and the patients together with their families, which is that no doctor can tell with absolute certainty that a condition will ultimately lead to death and that there is absolutely no chance of recovery. What they can do is present the patient and the family with the estimated probability of recovery together with the problems that can be faced in further curative therapy.
For example, people dying of cancer usually receive very aggressive treatment such as radiation or chemotherapy, these ways of treatment have side-effects which are very difficult to endure. Therefore, it is rational to want to quit the therapy if it cannot have positive results, and try to improve the quality of life. However, it happens very rarely that patients retain their rationality at such a difficult point in their life.
They tend to think that it is better to continue with the curative treatment despite its unpleasant side-effects because it implies even a small chance of recovery than to give up. However, the physicians can weigh out the negative consequences of continuing treatment and the chance of recovery it implies and determine whether it is rational to pursue further therapy. Once they do this, it is their obligation to present their judgment to the patient, and give advice on the right choice of further action.
An extensive line of research has to be conducted in this domain to equip the doctors with reliable information about the two variables so that they could give as accurate pieces of advice as possible. On the other hand, it is absolutely crucial for the patients to be realistic in their demands because only in that way can they get the best out of that most difficult situation without overburdening the doctors who already face a demanding task.
Finally, this type of care places special professional and moral obligation on the caregivers. First off, unlike the ordinary medical treatments, hospice demands that the caregivers be familiar with the patients life story.
The team has to find out about the most important things in the persons life, their goals, plans, etc. This is important because that way they can help the patient to bring their life to a close as a complete whole. Secondly, the team has to be informed about the nature of the persons disease in great detail in order to be ready for all possible issues that can come along the way.
Also, this is important because they have to know the limits of the persons abilities so as not to get them involved in activities which are physically too demanding and potentially harmful. Thirdly, caregivers have to keep in touch with current literature on bioethics and law. This is because in case of any kind of dilemma, it is best to know other peoples opinions, and learn from their mistakes and successes.
Furthermore, being informed about recent legislative changes in the domain, gives the caregivers an awareness of all legal options that are on their disposal in different situations. Fourthly, doctors and other caregivers have to know the limits of their abilities as well, because they are undoubtedly trained and able to help, but over or underestimating oneself can lead to serious consequences (Black, 1998).
In conclusion, hospice is a new interdisciplinary approach to medicine. As every other incipient discipline it faces challenges and problems. It demands a thorough cultural change in the relationship towards death and serious illness to occur first if we are to utilize the full potential of this discipline. Furthermore, the perception of hospice as a discipline has to be changed within the medical profession because many doctors tend to view it as a futile discipline because it cannot cure the patient.
Everyone has to realize that we as a society have an obligation to empathize and do whatever we can to help those who are in such a difficult situation. In that light, the government and all other institutions that fund scientific research have to consider increasing the amount of money invested in research in this domain because, as it has been stated, it is an incipient discipline which faces many problems.
At his point, doctors have to establish clear methods that can help in determining when is the right time to switch from curative to palliative treatment and educate their patients about its benefits. It is certain that the importance of this discipline will increase as the percentage of unnatural deaths is decreasing and life expectance increases. In the end, we may never be able to achieve immortality, in fact many claim that it would not be good at all, but we can certainly extend our lifespan and assure that the end of life be painless.
References
Black, T. (1998). End-of-Life Issues: Ethical Topic in Medicine. Web.
Cancer Facts & Figures 2012. (2012). Atlanta: American Cancer Society.
Gib, A. (2011). Hospice Care: Comfort and Dignity in the End. Web.
Medicare hospice benefits (2010). Baltimore, Md.: U.S. Dept. of Health and Human Services, Centers for Medicare & Medicaid Services.
Methia, R. (2010). Hospice Dying with Dignity and Treated With Very Special Care. Web.
Plocher, D. W., & Metzger, P. L. (2001). The Case Managers Training Manual. Gaithersburg, Md.: Aspen Publishers. What Is Hospice Care?. (2003). The Hastings Center Report, 33(2).
Exercise is a major component of a healthy lifestyle. In order to combat the negative impact of obesity and diabetes, it is best to include an exercise regimen in any health program. However, if the type of exercise required is similar to those of athletes, the strategy requires something more complicated than just physical movement alone. In the case of athletes, a primary concern is the need to sustain the ability to perform physically demanding tasks, and in order to accomplish that goal, the athlete needs to consume the right types and amounts of food sources.
At the top of the hierarchical structure for the most efficient and popular nutrient that supplies energy to the human body, one can find carbohydrates-rich foods. Good examples are rice, potatoes, and wheat. There are two types of carbohydrates, and these are: 1) complex carbohydrates and 2) simple carbohydrates (Gropper & Smith, 2013). With regards to complex carbohydrates, rice and yams are prominent examples, and one can also add wheat and cornmeal to the list. On the other hand, the best examples of simple carbohydrates are sucrose (found in fruits) and lactose (found in milk).
It is imperative that athletes and coaches are well aware of key nutritional principles in order to prevent sub-par performances due to nutrient deficiency (Gropper & Smith, 2013). Thus, sports nutritionists recommend a diet that is comprised of fruits, vegetables, lean meats, low-fat dairy, and whole grains (Shils & Shike, 2006). The keywords that they oftentimes use are variety and balance.
Nevertheless, when it comes to athletic performance, the American College of Sports Medicine and the American Dietetic Association issued a joint statement that athletes require adequate energy intake from macronutrients like carbohydrate, fat, and protein (Shils & Shike, 2006). It is through the consumption of the said macronutrients that athletes are able to acquire micronutrients like vitamins and minerals (Shils & Shike, 2006).
Basic Laws of Thermodynamics
In PC, Xbox, or PlayStation type of games, there are characters that gobble up energy directly from a canister or container. In real-life, athletes do not have the capacity to absorb energy directly from vegetables, fruits, and meat products. In fact, human beings are unable to do the same, because, in order to access the energy stored in carbohydrates or fats, the human body goes through a process based on scientific principles, specifically the Law of Thermodynamics.
According to the First Law of Thermodynamics: energy can be neither created nor destroyed, but can be transferred from one for to another and ultimately degrades to heat (Porcari, Bryant, & Comana, 2015). In order to acquire the energy stored in food products, the components had to go through a complex system. In a nutshell, the utilization of energy from food nutrients requires a series of energy transfers that occur through thousands of complex chemical reactions (McArdie & Katch, 2006). In addition, these complicated chemical reactions require the correct mixture of macro and micronutrients, and at the same time, the process is fueled by oxygen (McArdie & Katch, 2006).
In a typical exercise, the bodys muscles are responsible for moving the skeletal system in order to perform specific tasks like shooting a basketball or slicing through the water with a powerful dolphin kick. In order to perform this type of action, muscles must have the capability to contract, and this is made possible through the activation of the cells sodium-potassium pump. A reliable source of energy is required to sustain the action of the sodium-potassium pump.
An in-depth analysis of the chemical reactions required to fuel the body reveals that the primary source of energy is a compound called adenosine triphosphate ( ATP ). An ATPs basic structure is comprised of one adenosine molecule attached to three phosphate groups (Draper & Marshall, 2014). Each phosphate group is attached to the adenosine molecule using a high-energy bond (Draper & Marshall, 2014). When cells utilize the ATP as an energy source, a chemical process allows for the bond-breaking action that, in turn, releases a burst of energy. Staying true to the principle found in the First Law of Thermodynamics, the ATP compound is transformed into an ADP compound.
After identifying the exact process that enables cells to harness energy from an ATP compound, it is now easier to understand why cells are compelled to synthesize the same substance to ensure sustained homeostasis (Draper & Marshall, 2014). The initial stage in the synthesis of ATP begins when a human being ingests food. The digestion process is comparable to the mining of crude oil from petroleum oilfields. In the context of the human digestive systems wherein the body breaks down food products made from carbohydrates, fats, and protein, the catabolized compounds are glucose, fatty acids, and amino acids. Once the catabolized compounds are absorbed into the cells, the same is refined to become ATP.
There exists a continuous process of ATP synthesis to ensure the ready availability of the said compound. As a result, human beings have multiple metabolic pathways to choose from in order to synthesize ATPs. There are at least two anaerobic pathways and several aerobic pathways (Draper & Marshall, 2014). When it comes to the aerobic route, the cells utilize oxygen to create an ATP compound. On the other hand, ATP production through the anaerobic route does not require the use of oxygen.
Risk of Overtraining
The dedication and commitment to improve skills and endurance are the factors that separate champions from mediocre athletes. Thus, men and women seeking for gold and glory are committed to brutal workout and training sessions. In other words, winners are oftentimes seen as the first to arrive in the gym, and yet, they are also the last to go home. It is a good thing to spend several hours per day to hone skills and talent. However, athletes and coaches must take care not to subject the human body to the negative impacts of overtraining.
Overtraining is synonymous with excessive training frequency. Due to repeated actions, certain parts of the body experiences significant wear and tear. The first major risk of overtraining is a stress fracture. Lack of sleep and significant weight loss due to intense training can exacerbate the stress fracture problem of endurance athletes. Repeated stress causes micro-fractures, and when the body fails to increase bone mass in response to the stress, the area becomes weak and has a greater risk of succumbing to stress fractures.
Another major risk caused by overtraining is called the medial tibial stress syndrome (Stewart & Sutton, 2012). The colloquial term is shin splints (Stewart & Sutton, 2012). Athletes suffering from this condition complain of soreness and pain within the area of the medial tibia. One can argue that the root cause of the aforementioned problem is the hormonal imbalance due to intense and repeated physical activity. It is, therefore, important to teach the wisdom of taking periodic rests in order to allow the body to go through a process of healing and rejuvenation in order to accomplish certain important tasks.
The third major risk of overtraining is a triad of medical problems oftentimes linked to women. In this case, overtraining causes a phenomenon called the female triad (Stewart & Sutton, 2012). The term was coined to describe three related health concerns, such as: 1) disordered eating; 2) amenorrhea; and 3) osteoporosis (Stewart & Sutton, 2012). With regards to eating disorders it is harder to detect this problem in women compared to men due to the relatively lower levels of body fat among the members of the female population. Amenorrhea on the other hand is a malady characterized by the absence of menstrual periods. In fact, menstrual dysfunction is known to occur more frequently in female athletes than in the general female population (Stewart & Sutton, 2012).
Finally, with regards to osteoporosis, this health issue describes the lower-levels of bone density that oftentimes leads to bone fracture or musculoskeletal injury (Stewart & Sutton, 2012). Since women are prone to these types of medical challenges, it is imperative to monitor eating disorders within a team of athletes, because it leads to different problems that are interrelated. It is therefore imperative for women athletes to maintain an ideal body mass to prevent the onset of osteoporosis.
References
Draper, N., & Marshall, H. (2014). Exercise physiology: For health and sports performance. New York, NY: Routledge.
Gropper, S., & Smith, J. (2013). Advanced nutrition and human metabolism. Belmont, CA: Wadsworth Publishing.
McArdie, W., & Katch, F. (2006). Essentials of exercise physiology. New York, NY: Lippincott Williams & Wilkins.
Porcari, J., Bryant, C., & Comana, F. (2015). Exercise physiology. Philadelphia, PA: F.A. Davis Company.
Shils, M., & Shike, M. (2006). Modern nutrition in health and disease. New York, NY: Lippincott Williams & Wilkins.
Stewart, A., & Sutton, L. (2012) Body composition in sport, exercise and health. New York, NY: Routledge.
Dialysis is a concept that is applied in medicine. It refers to the process of replacing a kidney when it stops functioning properly. The kidney stops functioning properly because of renal failure. Dialysis is practiced to those patients whose kidneys fail to function properly. In the case of acute renal failure, patients may be stable, but their kidneys may stop functioning altogether.
This form of renal failure is referred to as End-Stage Kidney Disease (ESKD). In this case, the functions of the kidney decline after several years. This forces patients to seek kidney treatment so that they can survive (Stam 2). This paper will therefore look at dialysis as an alternative lifestyle.
Kidney treatment
There are various types of treatments that can be used to care for ESKD patients. The most common form of treatment that substitutes the lost functions of the kidney is kidney transplant. However, there are those patients who are not taken through the kidney transplant process because of medical reasons.
Moreover, other patients cannot receive kidney transplants because of inadequate supply of donor kidneys. In addition, other patients avoid kidney transplant because they argue that kidney transplant is not the best alternative for them. In this perspective therefore, most patients who have been diagnosed with renal failure should be subjected to dialysis to help replace the lost functions of the kidney such as water and waste materials removal (Stam 7).
Kidneys play a vital role in the body
Kidneys play a vital role in the body because they ensure that a persons body remains healthy. When the kidneys are healthy, they ensure that the body maintains a proper balance of water and minerals. The various minerals that the kidney regulates in the body include potassium, chloride, sodium, calcium, magnesium, phosphorus, and sulfate.
The kidney is also responsible for getting rid of the acid metabolism bi-products which cannot be removed through the process of respiration. Kidneys also play an important role in terms of facilitating the production of red blood cells and in the formation of bones. The drawback associated with dialysis is that it does not substitute the endocrine roles of the kidney (Henrich 15).
Kidney diseases have raised concerns all over the world
The rising cases of kidney diseases are raising concerns all over the world. This is because most health programs are being forced to struggle with the increasing demand for dialysis treatment. Most people in the world today are adopting unhealthy lifestyles which have led to increased cases of obesity. These issues have made a significant contribution to the rising cases of kidney diseases. Moreover, most of the worlds population is aging, and this has made renal disease to be regarded as an epidemic.
When the kidney fails a person goes through various life-threatening conditions. These conditions are mostly brought forth by the accumulation of waste products in the body. They make the fluid level in the body to rise significantly thereby leading to reduced production of urine.
Moreover, other conditions are observed such as cardiovascular disease, anemia, and traces of blood are also found in the urine. Extreme cases of waste products accumulation often lead to sudden death of a patient. Dialysis treatment is therefore essential in preventing the accumulation of waste products and therefore helps to clean the blood (Offer, Offer and Szafir 6).
Studies reveal that the market for dialysis equipment in the world has grown significantly. This is because of the increasing incidences of renal disorders. It is estimated that the annual rate of ESKD patients in the US and Europe is rising at a rate of 4-6 percent. On the other hand, the annual rate of ESKD patients in other parts of the world is growing at a yearly rate of 6-10 percent (Henrich 9). People with pronounced cases of diabetes and hypertension are the ones who face the highest risk of developing renal disease.
These diseases are becoming increasingly common all over the world. Experts stipulate that the worlds population is aging. The number of old people is projected to increase exponentially in the next two decades. Renal disease is common among old people. This is because they suffer from diseases that are highly related to renal disease. Moreover, old people experience functional changes in their kidneys thereby putting them at the risk of developing the illness.
The US market has the most renal equipment compared to the rest of the world. This is because the prevalence of ESKD cases in the US has grown significantly in the last decade. The treatment rate for ESKD cases in the US is twice the treatments that are carried out in European countries.
Most adults who are aged above 65 years old are the ones who are highly susceptible to the condition. Other countries such as China, Japan and Korea are also experiencing increased cases of renal diseases. The prevalence rate of the disease in these countries ranges from 10-18 percent (Stam 6).
The increasing prevalence of renal disease has made the demand for high-level services in clinics and hospitals to go up significantly. This is in order to enable them to provide dialysis treatment in an efficient manner. This trend has also played a major role in terms of broadening the gap between the number of nephrologists and the increasing number of patients. In this perspective therefore, a lot of pressure has been exerted on the existing resources.
Physicians are therefore required to cope with a big number of patients thereby lowering the quality of care being provided to the patients. This state of affairs is threatening the quality of care that is being provided to the patients. The renal dialysis equipment will therefore need to be adapted to the market changes thereby enable the equipment to manage the rising number of patients in a precise manner. Studies forecast that the global renal equipment will grow at an annual rate of 5.7 percent in 2012.
This rate is expected to grow and reach $ 14.3 billion by 2018 (Ronco and DellAquila 17). Therefore, it is true that most health institutions will be forced to invest most of their resources in acquiring renal equipment to enable them provide adequate care to their patients. Moreover, governments will need to participate in funding health institutions so that they can manage to handle the rising number of patients adequately.
Alternatives to dialysis
Most people with renal disease are finding it convenient to adopt dialysis as an alternative means of survival. However adopting dialysis has been noted to act as a frightening transition for most of the patients who have been diagnosed with the condition. This is because people worry about whether they will be able to support their families while maintaining the renal equipment.
The physical symptoms of renal failure are regarded as devastating in the world today. The most common alternative to dialysis is kidney transplant. However, there are other alternative forms of dialysis that people can adopt so that they can adopt healthy lifestyles. Therefore, most smart patients usually weigh the impact of the different forms of dialysis before deciding which one to adopt.
They mostly compare different forms of dialysis treatment before deciding on the one that suits them perfectly. However, though it is possible for a person to change those alternatives, it is important for a person to conduct thorough research on the various dialysis options available in order to determine which form of dialysis fits their lifestyle (Ronco and DellAquila 25).
Hemodialysis
When patients think of dialysis, hemodialysis is the common form of dialysis that comes into their minds. In this case, the patients are required to visit a dialysis center for specific days in a week. Whenever patients visit a dialysis center, they are normally hooked into a dialyzer.
The blood of the patients is made to flow into the dialyzer. The blood is filtered before it is returned back to the patient. Patients spend approximately 4 hours in a dialyzer whenever they visit the dialysis center. Patients are normally required to prepare for dialysis a few months before they visit a dialysis center so that they can allow the surgeon to match the patients circulatory system with the dialyzer (Offer, Offer and Szafir 32).
Graft and fistula access are the common forms of vascular access that most surgeons adopt. However, the National Kidney of Diabetes, Digestive and Kidney Disease (NIDDK) recommends the fistula access (Stam 12). This is because it involves connecting an artery direct into a vein thereby enabling the vein to be become stronger.
Whenever the artery is connected to the vein, more blood is made to flow into the vein thereby making the vein to become larger. This has the effect of making future needle insertions meant for hemodialysis easier and faster. However, patients should be patient because the veins usually take a few months before they can become larger.
Graft access is the second type of venous access. In this perspective, a catheter is implanted into an artery in order to facilitate dialysis. However, graft access is not effective because catheters usually get infected. The benefit of this form of dialysis is that it can be used in emergency situations. Hemodialysis requires a patient to commit a lot of time to dialysis treatment thereby limiting the patients ability to travel long distances (Henrich 9).
Peritoneal Dialysis
The best alternative to hemodialysis is peritoneal dialysis. Hemodialysis and peritoneal dialysis are two different concepts. This is because hemodialysis uses artificial filters whereas peritoneal dialysis involves the injection of the peritoneum that is found in the abdomens membrane. In this case, a catheter is implanted into the abdomen of a patient through surgical means.
The role of the catheter in this case is to remove impurities through the abdomens membrane. The catheter is allowed to accumulate the impurities for a period of time. This period is called the indwelling period after which the impurities are removed.
The process of adding and removing the impurities is referred to as the exchange. There are two ways of performing the exchange during peritoneal dialysis. These include the Continuous Cycler-Assisted Peritoneal Dialysis (CCPD) and Continuous Ambulatory Peritoneal Dialysis (CAPD). When patients are exposed to CAPD, they are expected to conduct manual exchanges for a whole day.
These forms of exchanges can be carried out in any place that is clean (Henrich 15). However, when patients are subjected to CCPD, they are expected to execute exchanges at night using a cycler. Most of the patients who prefer Peritoneal Dialysis do so because they are not limited to conducting exchanges in a dialysis center (Ronco and DellAquila 34). However, peritoneal dialysis exposes patients to infections especially when they are allowed to perform dialysis on their own.
Home hemodialysis
This form of dialysis has become popular in the recent years. The patients who are subjected to home hemodialysis are usually provided with a dialyzer and then taught how to use it. However, the most difficult part of the training is when the patients are required to know how to perform needle sticks (Offer, Offer and Szafir 23). This form of dialysis is carried out every night and it takes longer than other forms of dialysis. However, it is usually gentler on the body of a patient thereby making the laboratory values of a patient to normalize.
Conclusion
From the analysis therefore, it is true that dialysis is an expensive undertaking for most health institutions and patients. It is therefore important for governments and other funding organizations to ensure that they provide sufficient funds to medical institutions so that they can manage to provide their patients with effective and healthy dialysis treatment. This would improve the overall wellbeing of the patients with renal disease.
Works Cited
Henrich, William L. Principles and Practice of Dialysis. New York: Lippincott Williams & Wilkins, 2009. Print.
Offer, Daniel, Marjorie Kaiz Offer and Susan Offer Szafir. Dialysis without Fear: A Guide to Living Well on Dialysis for Patients and Their Families. London: Oxford University Press, 2007. Print.
Ronco, Claudio and Roberto DellAquila. Peritoneal Dialysis: A Clinical Update. New York: Karger Publishers, 2006. Print.
Stam, Lawrence E. 100 Questions & Answers About Kidney Dialysis. New York: Jones & Bartlett Publishers, 2009. Print.
Modern society has come to rely on medication to restore the body and mind to best functionality. Antidepressant medications, which are used to treat depression, have gained increased popularity in the United States. These drugs have taken the title of most frequently prescribed drug , suggesting that the US might be overusing them.
Use of Antidepressants
Antidepressants are used when a person experiences depression of a prolonged period and this depression interferes with the persons ability to carry out daily activities or enjoy himself (Rees 335). They interact with the brain leading to a change of moods and bringing about emotional stability.
Antidepressants take away the feeling of depression in a person and help them to feel the way they did before they became depressed. These medications can also block symptoms of panic therefore enabling a person to carry out with the daily tasks effectively.
Americans and the Happy Pill
There is a significant overuse of Antidepressants in the US. A report by the CDC revealed that antidepressants were the third most common prescription drug taken by Americans of all ages in 2005-2008 (1). Physicians are recommending and prescribing antidepressants as treatment for depression and insomnia at a higher rate than then did in the past.
Attarian and Schuman observe that in the US, antidepressants have become some of the most commonly recommended and prescribed treatments for insomnia and depression complaints (18). This observation is supported by the CDC which documents that in 2005, about 5% of the total drug prescriptions by physicians all over the US were for antidepressants.
Reasons for Increased Use
A number of reasons have contributed to the significant increase in antidepressants use by Americans. Antidepressants create an illusion of happiness leading to their overuse by Americans whenever they feel sad or low. Americans have developed the habit of using medication to deal with mild depression or general low feelings that do not require the use of antidepressant medications. Rees notes that antidepressants provide a quick means for a person to feel better (Rees 335).
The decrease in the quality of life for most people has increase risk of depression and the subsequent use of antidepressants. With the high levels of stress that people experience, they are likely to experience sadness and frustration that lead to depression at higher rates (Attarian and Schuman 17). This overall decrease in quality of life for many people in the US has contributed to the overuse of antidepressants.
There has been a dramatic shift towards the use of antidepressants to cure conditions such as insomnia and anxiety disorders. While therapy was the most common means of dealing with anxiety disorders, there has been a trend towards using medication to deal with these conditions.
With insomnia, in the past alcohol and sleeping pills were the most commonly used hypnotics among insomniacs. However, since the 1990s, antidepressants have become the preferred means of treatment of insomnia (Attarian and Schuman 18). Interestingly there is no hard evidence regarding the efficacy of these medications in dealing with insomnia.
Conclusion
Antidepressants use in the US is at an all time high. This is a troubling thing since these over prescription might decrease the effectiveness of the drugs. Reliance on the drugs to treat anxiety conditions even when other option such as therapy might be better is detrimental to the well being of the patient. Steps should therefore be taken to reduce the overuse of antidepressants in the US.
Works Cited
Attarian, Hrayr and Schuman Catherine. Clinical Handbook of Insomnia. NY: Springer, 2010.
Center for Disease Control and Prevention (CDC). Antidepressant Use in Persons Aged 12 and Over: United States, 20052008. 2011. Web.
Rees, Alan. Consumer Health USA. Boston: Greenwood Publishing Group, 1997.
National Council Licensure Examination (NCLEX) is an examination administered by the National Council of State Boards of Nursing (NCSBN) to graduate nurses in the United States before they can obtain a practicing license.
An NCLEX test blueprint is a document produced by NCSBN, which contains a summation of what is assessed in the NCLEX examination as well as the core values of nursing practice. The blueprint serves as a guide for aspiring nurses and student nurses who need to learn the basic requirements of nursing and nursing examination. The blueprint is valuable in exam preparation and as a study guide.
Client Needs in the NCLEX Test Blueprint
In an NCLEX blueprint, client needs are the actions and expectations of the nursing practice in a patient-centered approach (National Council of State Boards of Nursing, 2013). The core of nursing revolves around a scientific nursing approach backed by clinical reasoning, respect and care for clients and persistent quest for knowledge. Client needs categories in an NCLEX test blueprint refer to the four main groups in which the blueprint is organized. Two of the four categories are further divided into smaller sub-categories.
Safe and Effective Care Environment
This category is concerned with matters of safety when caring for patients whether in the hospital or in the home environment. In nursing, emphasis is placed on the maintenance of an environment in which compassion and care for patient wellbeing is maintained (National Council of State Boards of Nursing, 2013).
This category talks about protecting patients and healthcare providers from injuries, and advocating for the rights of patients and other nurses. It includes the giving out of medicine to clients, safe usage of medical apparatus, safety precautions to avert harm and infection, isolation measures, and ethical considerations. There are two sub-categories under safety and effective care management, which include administration of care and safety and infection management.
Health Promotion and Maintenance
This category includes measures for birth control, communicable diseases, pregnancy and childbirth, and general growth and development. It is vital for the nurse to understand all aspects of human growth and development such as nutrition and pregnancy complications in order to be prepared for any situation.
Psychosocial Integrity
This category deals with caring for the psychological, social and emotional health of the client. Examples of areas under this category that nurses ought to pay attention to include stress management, support systems and therapeutic communication.
Physiological Integrity
This category deals with the physical wellbeing of the client through care and is made up of four subcategories. Examples under this category include non-pharmacological comfort interventions, pharmacological pain management and therapeutic procedures.
Reference
National Council of State Boards of Nursing. (2013). 2013 NCLEX-RN Detailed Test Plan: Candidate Version. Web.
Traditionally considered one of the most dangerous drugs, heroin could definitely use a better reputation. Although the chemical compound is called diacetylmorphine, the substance has gained a notorious recognition by its nickname, heroin. Prohibited all over the United States and in most countries of the world, heroin, weirdly enough, is also used for a number of healthcare purposes.
Science of Caffeine. Web.
As it has been mentioned above, heroin is traditionally considered an illegal substance and, therefore, is prohibited from use in most states all over the world. Nevertheless, heroin is still prescribed in specific medical cases as a critical care unit. More to the point, heroin is often utilized as a controlled drug for the people who are severely dependent on drugs and are undergoing a course of replacement therapy.
It should also be noted that the status of heroin is currently considered in some states as a substitute for morphine; still, its comparatively strong effect is considered a major obstacle on changing its status. It should also be mentioned that heroin is used in the course of producing various derivatives, such as naloxone, naltrexone and nalorphine (Leavitt 2). The aforementioned medicine is used as the means to address the aftereffects of drug overdose.
There is no need to mention that heroin is also widely misused. No matter how well the basics regarding the use of drugs are taught, there will always be people who are careless enough to jeopardize their lives for the sake of a cheap thrill. According to the statewide statistics, the rates of illegal use of heroin in the USA have dropped slightly since the last year.
Nevertheless, heroin abuse remains one of the key concerns for the present-day U.S. healthcare services, as well as the healthcare services all over the world. The report published in 2014 says that an estimated of 13.5 million people all over the world use or have used opioids, which heroin also belongs to (DrugFreeWorld para. 1).
Speaking of heroin users only, they make 9.5 million people at present, and the situation does not seem to get any better despite the propaganda promoting healthy lifestyle and the dangers of heroin. Speaking of the U.S., the statistics regarding the use of heroin does not provide the exact data, since people are usually reluctant to confess in using drugs; however, as the anonymous surveys show, at least 700,000 people in the United States need urgent medical help and the assistance of professionals (Michaels House para. 6).
The need to address the problem of heroin use is not as far-fetched as the drug addicts may want it to be; quite on the contrary, unlike less efficient drugs, such as marijuana, heroin has a fast and irreversible effect on peoples health. It should be mentioned that long-term and short-term effects are traditionally distinguished. A
mong the latter, such problems as rush, nausea and vomiting, depressed respiration, etc. are typically observed (National Institute on Drug Abuse para. 5). As for the long-term effects, the addiction, collapsed veins, abscesses, and numerous infectious diseases, including HIV/AIDS, hepatitis C, and many others, should be named (National Institute on Drug Abuse para. 5). Heroin remains among the most dangerous substances, and its use must be reduced by all means possible.