Category: Health & Medicine

Hemophilia: a Rare Disease

Hemophilia is a rare inherent genetic disorder that affects the blood-clotting processes. Patients suffering from this disease cannot form blood clots properly, which brings the possibility of any injury or surgery being fatal due to the inability to stop the bleeding. Three types of hemophilia are differentiated by the lack or absence of different blood clotting factors. Type A is connected to a lack of factor VII, type B  factor IX, and type C  factor XI. According to Srivastava et al., despite the advances in treating hemophilia, including medicaments and gene therapy, many patients die before adulthood due to a lack of awareness. Therefore, it is important to continue advancements in treating to make it more available and affordable and informing the public and medical professionals about hemophilia.

General Overview of Hemophilia Management

Hemophilia is an incurable genetic disease at the present moment; thus, even the word cure might not be appropriate. Therapy and management of this disorder first mainly lie in providing the concentrates of blood clotting factors or hormones that stimulate the production of these factors, according to Srivastava et al. It is commonly referred as replacement therapy, and requires constant monitoring of the patients condition and adjustments based on their needs. It is administered after genetic evaluation, and often supported by hemostasis rebalancing drugs to achieve effectiveness of the concentrates. Prophylaxis is sometimes also used to manage the condition if needed. It is applied to change the flow but restricted natural history of bleeding. Overall, the effective treatment of hemophilia encompasses several different methods and requires a comprehensive framework to monitor the patient and adjust to their condition accordingly. It may also include mental health treatment and advocacy to protect the patient and provide them with the needed resources.

Emicizumab: Non-Replacement Treatment

Aside from the restricted and supplementary use of prophylaxis, according Mannucci, emicizumab is a new promising treatment o hemophilia. With this new advancement, patients are expected to live about ten years less than the average male expectancy, prolonging it. Emicizumab or a bispecific monoclonal antibody focuses on promotes the production of trombin, blood clots, by mimicking a blood-clotting protein FVIIIa. It works despite any deficiency in factors or any presence of inhibitors. This property allows for the patients with the inhibitors to be effectively treated with less frequency of the drug administration.

Gene Therapy for Hemophilia

Being a genetic disease, hemophilia attracts a lot of genetic research into its treatment and prevention, according to Batty and Lillicrap. It is another alternative for replacement therapy, which also has a potential for the patient not to be stuck in the frequent and expensive administration of the drugs and check-ups. According to Batty and Lillicrap (2019), All successful, pre-clinical and clinical studies to date have utilized recombinant adeno-associated viral (AAV) vectors for factor VIII or IX hepatocyte transduction (p. 95). In all of these trials, patients reported a significant improvement in the quality of their lives. No side effects, toxicity, or carcinogenic factors were not found during the research and its aftermath, which provides hope for this direction in hemophilia treatment research and possibility of expanding the options for the patients.

Importance of Awareness and Support for the Patients

According to Srivastava et al., many people suffering from hemophilia may not be aware of the treatment options or have necessary funds to cover it. Therefore, they argue that it is essential to raise the awareness and provide advocacy for the patients, demanding the coverage from the government. Investment in research on hemophilia can also not only provide more options, but possibly make them more affordable for the patients, as their life span and overall quality of life depend on these treatments.

Works Cited

Batty, Paul, and David Lillicrap. Advances and challenges for hemophilia gene therapy.Human molecular genetics 28.R1 (2019): R95-R101. Web.

Mannucci, Pier Mannuccio. Hemophilia therapy: the future has begun.Haematologica 105.3 (2020): 545. Web.

Srivastava, Alok, et al. WFH guidelines for the management of hemophilia.Haemophilia 26 (2020): 1-158. Web.

Introduction

• Previous chapters covered concepts of exposure and dose.
• A framework to link environmental exposure, internal dose and physiologic responses was described.
• This chapter describes approaches to quantitative modeling of exposure and dose.
• The importance of characterizing the temporal dynamics of the exposure-risk relation will be shown.

The Starting Point: The Exposure Profile

• Exposure is a complex, time-dependent quantity that must be summarized before its use in a model
• Exposure history to a hazardous agent by a worker can be summarized as:

where: xit =exposure level for worker I in time periods, t= 1,2,3&ni.

• Exposures must reach target organs and reach critical levels before injury occurs
• The profile of tissue concentration can be modeled as:

where: bit =tissue burden for worker i in time periods t= 1,2,3& ni

ni = No. of time periods of exposure of subject i prior to T.

• Burden of dose are not usually directly measurable.
• Hence, cumulative exposure is normally used.
• It is the time integral of exposure intensity.
• Duration of exposure is also a commonly used summary measure.
• If exposure intensities are constant, the duration of intensity will be proportional to dose.

Exposure-Dose Relation

• Knowledge of ventilation rate can help compute the quantity of toxins inhaled.
• Use of ambient exposure data without accounting for dose can lead to wrong findings.
• Exposure can occur through lungs, skin or ingestion.
• It can be assumed that risk is proportional to dose.
• Hence, cumulative exposure is proportional to risk.
• However, risk may not be directly proportional to dose.
• This occurs when the degree of response to a given amount of dose varies over time.
• This calls for the use of a nonlinear model.

Dosimetric Model

• DM is used when risk is not proportional to dose.
• It is constructed based in explicit hypotheses about exposure-dose or dose-risk relations.
• DM can be used in the same way as summary measures of exposure.
• Steps in developing a DM:
  • Development of model structure;
  • Estimation of model parameters;
  • Validation and testing of model;
• Model parameters are estimated from previous studies or directly from data.
• In the latter method, the data set must be fairly large and the number of unknown parameters small.

Incorporating Inter-Individual Variability into Dose Metrics

• DMs provide a formal , quantitative way to integrate data on individual risk modifiers into an epidemiologic analysis.
• DMs account for differences in ventilation rates to improve risk estimation.
• E.g. the effects of Ozone concentration on lung function are better explained by the product of ventilation rate and ozone concentration.
• Ozones airway effects are better predicted by more variables.*
• The human airway response to Ozone diminishes with age.
• Hence, a good DM must account for all of these variables.
• Exposure weighting is used.

*Studies show that Ozones airway effects are better predicted by complex functions of duration, Ozone concentration, and ventilation rates and not just a mere product of these functions.

Exposure Weighting

• Even in the absence of strong biologic hypotheses, a summary measure of exposure is still required.
• Average values or cumulative measures can be used.
• The Seixas Exposure Index weights the different exposure indices.

The Seixas Exposure Index

• Seixas has described a model to measure optimal weights of the form:

where:

• Ei =exposure index for the ith subject;
• Wij =indicator for the timing of exposure Xij;
• Xij =exposure intensity for subject i in time period j ;
• a and b are weighting parameters.

Induction Time Analyses

• This is another empirical approach to exposure weighting.
• ITA assumes that expected contribution of exposures will be constant during some time period.
• Both recent exposures and exposures that occurred in the more distant past are considered etiologically irrelevant.
• It can help to determine whether carcinogens operate late or early in the etiologic process.

Multistage Cancer Modeling

• Is an improvement of ITA.**
• It is expected that all time periods should contribute some risk.
• MCM assumes that for cancer to ultimately occur, cells must pass through k distinct, heritable changes in a specific sequence.
• The simplest MCM model assumes that the background rate for a particular transition, j, is constant.
• In more complex models, the background rate may vary with several variables.***
• The underlying theory ni MCM is that cellular change j occurs with a background rate Rj that is independent of age.

**A limitation of ITA is that some time periods receive full weighting while others receive zero weighting

***In more complex models, the background rate may vary with factors such as age, condition of neighboring cells, or time since the cell experienced changes

Choosing the Best Measure of Exposure or Dose

• Epidemiologic studies can be expensive and time consuming.
• Selecting just one measure of exposure/dose can be hard.
• In practice, many diverse measures are tested.

Criteria for Choosing the Best Measure of Exposure

• Generally, the better index will give a better statistical fit;
• Different indices have different scales and cannot be directly compared;
• Reasons for choosing a specific exposure index/dose metric can include:
  • Ease of interpretation and comprehension;
  • superiority in statistical performance;
• Dose metric may be preferable to exposure index if:
  • There are several routes of exposure;
  • If one wants to estimate the risk via all routes combined;
  • If one wants to be able to use the results to make predictions on risks resulting from varied exposures;
  • If one wants to consider interactions among different exposures.

Strengths and Limitations of Dose Modeling

• Strengths:
  • It may improve study validity and precision;
  • It may allow epidemiologists to investigate mechanistic hypotheses formally; ^aa
  • It makes it easier to extrapolate results especially when multiple routes of exposure are involved;
• Weaknesses:
  • Dosimetric models require additional assumptions;
  • Misclassification can occur if assumptions are incorrect;
  • There is always poor quality of the available exposure data;
  • Dose modeling questions shift away from the study of an environmental quantity to a physiologic one.

^aa It may allow epidemiologists to investigate mechanistic hypotheses formally in a way that is not possible with simple measures of exposure.

As part of this work, it is required to analyze an article dedicated to the scientific discovery of dinosaur skin healing and outlining the background and prospects for this area of research. It is required to demonstrate the novelty of the selected study, determine the circumstances of the study and give its comparative characteristics. The work also demonstrates the CSE citation technique that does not recommend using the direct use of text from other peoples articles.

The origin of this study is the discovery in 2008 by Lindham-Sollar of the presence of skin pathology in Psitacosaurus, the predecessor of horned dinosaurs. The authors of this article, however, delve into the study of skin damage, since the previous article did not explain whether the wound was in vivo and whether it had signs of healing (Rothschild & DePalma, 2013). Using Garosaur skin taken from the Palm Beach Museum of National History, the researchers matched it to a skull that had been damaged by a predator attack (Rothschild & DePalma, 2013). Judging by the impressions of the teeth, the researchers are able to establish that most likely this attacking dinosaur is a Tyrannosaurus rex.

Because Lingham-Sollar recognized the pathology in the animal without signs of healing on the wound, it was impossible to determine how it had been obtained. This problem was bypassed by the authors of the study, who were able to determine that tissue wrinkles appeared during the healing process of the scar. The chaotic overgrowth patterns were proven similar to the healing of the skin in modern reptiles, longer than in mammals (Rothschild & DePalma, 2013). It is also important that the authors of the article examined these wounds directly during the excavation process, which had a positive effect on the preservation of evidence (Rothschild & DePalma, 2013). Thus, the first hypothesis did not have sufficient evidence of dinosaur skin overgrowth due to negligent excavation  a problem that was corrected by the next hypothesis in this article with some evidence.

It can be assumed that Tyrannosaurus was an active predator, basing this answer on the image of this prehistoric animal in popular culture. Tyrannosaurus rex could not only suddenly attack as a hunter, but even pursue its prey. However, in this case, the answer is also based on the fact that there was a noticeable prolonged healing process on the skin of an injured dinosaur. It follows that the discovered dinosaur managed to convince or somehow escaped the fatal attack before it finally died. The answer is thus based on fictitious information, however, it is not contradicted by the data found in the article, which justifies its high probability of fidelity.

A feature of the CSE format is the principled refusal to directly quote the text used in the work. Even if the article is retold within the framework of this format, the author should in every possible way refrain from placing the text in quotation marks and paraphrase it in every possible way. This seems to be a valuable skill because it gives the author of the new text the opportunity to manage the narrative and organize the text of the article independently. Also, this freedom of language allows the researcher to think more independently, avoiding excessive citation and finding their own academic style. This format really demonstrates the flexibility in using a quote, allowing one to express the essence of other peoples developments in ones own words. This can greatly facilitate the transfer of information in the new text, making it more accessible to the necessary circle of readers and using only the necessary information without excess.

Reference

Rothschild, B.M., & Depalma, R. (2013). Skin pathology in the Cretaceous: Evidence for probable failed predation in a dinosaur. Cretaceous Research 1e4. Web.

Introduction

Nurse practitioner (NP) licensing boards across the country, usually a states Board of Nursing (BON), employ scope of practice (SOP) as a foundation for professional regulation. The procedures, actions, and processes that NPs can do as part of their professional licensing are defined by this concept. A family nurse practitioner (FNP) cares for a wide range of patients and thus has a wide scope of practice. An FNP may be helping pediatric or geriatric patients who have different needs and therefore require a varied level of care. In terms of settings, an FNP can work in private hospitals or outpatient facilities located in rural or urban areas. For this reason, anyone willing to work in the family health sector is expected to apply a high level of integrity and accountability when interacting with patients at all levels.

One of the critical areas of practice for an FNP is the provision of mental health care. FNPs are the first line of mental health care as they are the ones to assess and assist patients before other caregivers. According to research, there is an increased need for healthcare workers in the FNP sector. This follows from the high prevalence of mental health challenges. In the U.S., for example, it is estimated that one out of five adults is suffering from a mental health problem (Balestra, 2019). This makes the role of an FNP very crucial for the sustenance of families and communities, by extension. The research by Balestra (2019) further reveals that adolescents in the range of 14-18 years also suffer from a mental disorder, accounting for 49.5% of mental disorders. An FNP, therefore, has to learn how to approach mental health challenges affecting both children and adults.

The scope of practice for an FNP entails the initial diagnosis of uncomplicated mental health challenges and treatment of mild symptoms. Depending on the states regulation, FNPs should understand the depth and breadth of their practice to avoid violations that could result in legal suits. According to Balestra (2019), FNPs are required to test their patients for mental disorders, which could entail anxiety, depression, and such symptoms. An FNP is expected to make an informed judgment of the extent of the problem and the level of care needed. Although they are permitted to treat mild cases, they are expected to refer chronic cases to a psychiatric nursing practitioner. Failure to refer such cases may result in a violation of the SOP with severe consequences to follow.

In summary, FNPs are frequently the first line of treatment for patients with mental diseases such as depression, anxiety, and attention deficit hyperactivity disorder. According to Balestra (2019), FNPs are well-positioned to deliver mental health treatment, including everything from mental health screening to early intervention, consistent with the FNP concept of patient-centered care. However, compared to psychiatric mental health NPs or other behavioral health professionals, FNP education primarily covers a portion of mental health care and may not adequately train FNPs to manage patients with complicated mental diseases.

Role Delineation

One crucial role of an FNP is the management of patients mental health conditions. This role begins with the understanding family health care necessitates nurses to ensure their patient avoids risk factors related to mental disorders, gets diagnosed properly, and receives full treatment (Balestra, 2019). My goal here is to ensure that a patient fully recovers from all mental health conditions and pursues a healthy life. To meet this role, I will apply the knowledge gained in training and experiences to provide all necessary details to the patient before mental health diagnosis. This implies that I will have to inform the patient why they need to be tested for mental health disorder to facilitate their informed consent on the same. Following diagnosis, I should be in a position to offer the first line of care to handle all the mild cases and refer the chronic cases to a psychiatrist for specialized care.

The second crucial role of an FNP is establishing a good nurse practitioner-patient (NP-Pt) relationship. This relationship is very critical in the scope of practice of an FNP. It determines how well an FNP performs their duties and impacts the response from the patients. I will cultivate an excellent NP-Pt relationship through good communication skills and ethical conduct. Caring for family mental health requires nurses to fully understand their patients and respect their cultural and ethical beliefs (Balestra, 2019). From my experience, patients respond better to treatment when they have established a good rapport with the NP. As a primary caregiver for family mental issues, I will be very close to the patients to enable them to freely discuss their challenges and seek solutions that give satisfactory results.

Conclusion

In conclusion, an FNP is a crucial caregiver responsible for family health care. The scope of practice for an FNP is quite extensive since it involves people from all age groups. The varied needs and conditions of the patients call for the application of effective health management practices. Establishing a good relationship with patients is akin to maintaining a healthy family and a successful career practice.

Reference

Balestra, M. L. (2019). Family nurse practitioner scope of practice issues when treating patients with mental health issues. The Journal for Nurse Practitioners, 15(7), 479482.

Introduction

The article Comfort in Labor: Like Being Able to Exhale examines a unique issue in maternal health that past researchers have given little attention. The purpose of this paper is to analyze the credibility, research processes, and findings of the selected and describing whether the insights are applicable in practice. The authors use content analysis to gather revelations from eight women who had successful vaginal births about the concept of comfort. Hall et al. (2020) observe that women understand the concept of comfort but usually lack adequate capacity to make the best choices due to the restrictions and practices of caregivers. From the completed appraisal, it emerges that the article is credible and capable of transforming midwifery practice by introducing evidence-based practices that can improve womens comfort index in childbirth.

Analysis

Credibility

This article is a reputable source since all the four professionals have PhDs. These qualifications show conclusively that they understood the subject and were capable to offer desirable inputs. The article is also peer-reviewed and was published in the 2020 edition of The Journal of Perinatal & Neonatal Nursing. The absence of grammatical errors makes the work easy to follow and understand. The headings are properly designated, thereby encouraging more readers to seek adequate insights from it. The choice of the topic is also appropriate and capable of analyzing a topic that has not attracted attention of many professionals. The absence of comfort in childbirth could have negative impacts on women health (Hall et al., 2020). The relevant board approved the research while the scholars obtained informed consent from the respondents. The consideration of ethical principles throughout the work makes the article relevant and information. These approaches promoted the level f confidentiality and participation.

Integrity

Methods

To complete the study successfully and offer timely insights, the researchers adopted the use of content analysis. This strategy worked effectively for the topic since inadequate information was available. The approach allowed only women aged 18 and above to be included in the study (Hall et al., 2020). Such respondents were competent in Spanish or English language, had given birth naturally without challenges, and no prior surgical or medical complications (Hall et al., 2020). The professionals adopted a purposeful data collection and recruitment strategy. Women with diverse backgrounds were selected from a social parenting website. Informed consent was obtained after which the Principal Investigator (PI) screened the right candidates for inclusion. Individuals were interviewed twice depending on their convenience. The researchers recorded the information using audio technologies after which transcription was done.

For the Analysis section, it is agreeable that proper journaling techniques were considered to explore assumptions and remove biases. This was achieved through the inclusion of several professionals, such as a public health researcher, midwife anthropologist, and nursing qualitative researcher, and a midwife PhD student (Hall et al., 2020). Using notes and conceptual maps, the investigators managed to create a detailed description of respondents experiences and meaning of comfort during childbirth. These efforts helped the researchers remove biases and obtain the required insights.

To achieve rigor, the involved professionals pursued various strategies to establish validity. Some of them included collecting rich, thick data from appropriate participants who have knowledge of the research topic (Hall et al., 2020, p. 40). The included women had given birth in a natural way and were from different ethnicities. Coding approaches helped the professionals with unique experiences helped remove any form of bias. The inclusion of women who had experienced pain and those who did not increased the rigor of the study.

The choice to have sample of eight women with diverse backgrounds made it possible for them to meet the intended research aims. To recruit the respondents, the professionals considered ethnic backgrounds, nature of past births to ensure no surgical operation or medical problem was recorded, and the ability to speak Spanish or English languages. Those who had undergone any form of surgery were excluded. They went further to ensure that the sample included women from different regions. The set inclusion criteria focused on these issues: past births should have been normal, no medical problem or history, and willingness or availability for the study. This approach was helpful since it supported the study and made it possible for the researchers to present meaningful observations (Hall et al., 2020). The sample size comprised of eight respondents was sufficient since it allowed them to offer diverse views and understanding of the concept of comfort in labor. Consequently, the emerging insights were informative and capable of helping more professionals to meet the demands of more women during childbirth.

Results

The researchers relied on the adopted methods to gather adequate information, thereby being able to present high-quality results. They categorized their findings accordingly depending on the intended topic. For instance, they indicated that the participants defined comfort as the ability to experience relaxation, calmness, and reduced tension (Hall et al., 2020). The respondents believed that comfort would be equated to the ability to have needs met while promoting the much-needed human connection. They went further to identify comfort with the process of applying knowledge to identify and formulate desirable choices, exercising voice, and pursuing desirable feelings. When the level of comfort was compromised, the respondents indicated that body shame would be the leading cause. This problem was evident when the existing conditions or workers were socially unresponsive or impolite (Hall et al., 2020). This means that the involvement and actions of nurse practitioners and midwives throughout the delivery process could dictate the individuals experience of comfort.

From these observations, it is evident that the authors have linked their research method with the collected results. The findings are coherent and resonate with the roles, expectations, and practices of all stakeholders in childbirth. The results are inclusive and offer diverse aspects of comfort and how it affects women in need of labor services. These insights expose the unique strengths and contribute significantly to maternal health. The researchers combine their findings to describe how pain and comfort could coexist during labor and subsequent childbirth (Hall et al., 2020). While pain relief was a common practice, it occurred that it could not always be the path to comfort. Additionally, the investigators acknowledged that women understood the concept of comfort. However, the role and expectations of caregivers in medical facilities affected their capacity to make the right choices. They conclude by encouraging policymakers to transform the available aspects of labor by integrating aspects of choice ad mobility.

Contributions and Coherence

The results of the selected article reveal that the concept of comfort remains poorly implemented in medical facilities. While women appear to have a proper understanding of the notion, their experiences reveal that clinicians and midwives do little to promote it. Some of them fail to record improved experience since they are unable to make proper choices. The autonomous position of medical professionals impacts the experiences and goals of women during labor (Hall et al., 2020). The promotion of a new model to implement comfort and introduce evidence-based guidelines to pursue is a necessity. The consideration of these issues could support a paradigm shift and support the experiences of more women in childbirth.

The findings and discussions in this article provide strong reasons for improving comfort in labor wards. First, the reader understands that pain is always a common problem during childbirth, and it might not mean the absence of comfort. Those in maternal health need to foster comfort from a holistic perspective to maximize relief and relaxation. This strategy means meeting the clients spiritual and bodily needs. The choice by caregivers could affect the experiences of most of these women (Hall et al., 2020). These issues, therefore, explain why maternal health should start to prioritize comfort while focusing on pain management approaches. The move could contribute to a holistic and contented birth experience for most of the women in need of such services.

These insights resonate with the expectations of all professionals and scholars in midwifery. Those planning to offer similar services in the future need to embrace these ideas and consider better ways to empower women. When the level of comfort is improved, a holistic experience emerges that can empower the clients to support their newborn babies across the lifespan (Hall et al., 2020). These considerations are, therefore, essential and capable of improving the nature of care delivery in midwifery.

Conclusion

The analyzed article is credible since all the authors have reputable credentials, including PhD and MDs. The research method is concise, inclusive, and evidence-based. The reader is capable to follow the work because the researchers have used the best language and academic approach. The revelations support the fact that comfort is a missing element in midwife departments. Clinicians and caregivers need to merge the studied concept with pain management to maximize the holistic health experiences of more women in need of childbirth services.

Reference

Hall, P. J., Foster, J. W., Yount, K. M., & Jennings, B. M. (2020). Comfort in labor: Like being able to exhale. The Journal of Perinatal & Neonatal Nursing, 34(1), 38-45.

Relief, risk and renewal

Scope

This article addresses the Australian suburb community residents perspective on using alternative and complementary medicine in the current environment. The matter is examined through the lens of an anthropological study conducted in a suburban area referred to as Oceanpoint (Connor, 2004). The aim was to investigate the underlying reasons behind the increasing proliferation of alternative treatment options within the community. To fulfill the purpose of the study, its author analyzes 111 semi-structured interviews, encouraging the respondents to reflect upon their lives and the role of complementary versus conventional medicine in them.

Argument

From the perspective of this article, the anthropological considerations of illness, its origins, and remedies become the focus of attention. According to Connor (2004), these psychological and ethnographic aspects prevail within the community. More specifically, personal views likely prevail in society, bearing more weight than evidence-based scientific knowledge. Thus, the authors findings are likely to improve the understanding of the factors that affect the decision-making process of regimen seeking treatment. The

Conclusion

Even though the governmental perspective exclusively supports biomedical interventions, complementary medicine has seen an increasing proliferation within the Australian communities. Connor (2004) concludes that the perceived effect of treatment is more valuable for the Oceanpoint residents than evidence or scientific knowledge. While the exact reasons may vary, in most cases, the use of mixed regimens is dictated by the inner desire to undermine the biomedical side of the disease through self-actualization. Overall, the authors highlight the collision of facts and subjectivity that prompts people to rely on alternative and mixed therapies when conventional medicine is deemed ineffective. This conclusion is logical form an anthropological perspective, meeting the purpose of the study.

Parental management of childhood complaints

Scope

The scope of the study revolves around the increasing use of over-the-counter medicines (OCM). According to Trajanovska et al. (2009), this topic is related to the advice-seeking behavior of parents, responding to their childrens complaints. Thus, the study examines this behavior to understand the factors that affect parents decision-making. To do so, the authors recruited 325 parents and examined their decision-making patterns. This sampling will likely provide insight into the matter at hand, promoting the safe use of OCMs.

Argument

The primary argument of the study states that parents seek convenient options of treatment that would combine safety with efficiency. Trajanovska et al. (2009) stated that most parents actively used OCMs in less serious conditions, such as rash and wheeziness. However, 82% of the respondents follow doctors advice when purchasing specific over-the-counter medicines. Interestingly, the medicines perceived effectiveness in the past is another critical factor, combined with the insights from families and friends. This shows that parents want to relieve their childrens complaints with the most efficient solutions that are easily available. In addition, past knowledge continues to reside within familial units, as parents are not prepared to experiment with their childrens treatment.

Conclusion

The extensive use of OCMs is inconsistent with the growing importance of self-care within communities. Trajanovska et al. (2009) conclude that it is easier for parents to purchase such medicines without the need to make long clinical visits and obtain prescriptions. In this regard, they appear to opt for a combination of safety, efficiency, and availability of symptom management options. In addition, the reliance on past knowledge and experience is another factor in decision-making. The authors make a valuable contribution to understanding human reasoning, paving new avenues for medical community education in the future.

Comparison

Both presented articles examine the profound factors determining human decision-making when seeking medical treatment. However, they introduced different contexts in which varying variables exercise their effect. From one perspective, personal self-care favors complementary medical practices against doctors advice. On the other hand, parents resort to professional opinions when their children need help. Thus, child care introduces new variables, implying that people may be less considerate when help is needed by themselves. At the same time, both articles emphasize the role of past knowledge and community experience in treatment options.

Reference List

Connor, L. H. (2004) Relief, risk and renewal: mixed therapy regimens in an Australian suburb, Social Science & Medicine, 59, pp. 16951705.

Trajanovska, M et al. (2009) Parental management of childhood complaints: over-the-counter medicine use and advice-seeking behaviors, Journal of Clinical Nursing, 19, pp. 20652075.

Introduction

The problem of working with aggressive mentally ill patients requires an integrated approach and appropriate competencies from nurses. First of all, person-centered care implies the subjective and individual context of conducting medical activities and patient care (American Association of Colleges of Nursing, 2021). It is worth noting that the knowledge accumulated in research tends to a certain degree of universality of approaches, at least within the framework of a specific mental disorder. Competence consists in applying only the necessary accumulated knowledge within each case. Avoidance of aggression is a consequence of building a trusting relationship with the patient, which is the implementation of a pre-prepared plan of care. DNP in this situation may be concerned with evaluating the broader practical implementation of approaches that have been successfully applied within a single study.

Discussion

The second most important competency is the Scholarship for the Nursing Discipline. Since the problem of burnout in the mental health of nurses who experience aggression from patients with mental disorders is still relevant, this area requires additional research (Drukker, 2021). This issue leads to the loss of essential personnel in the early and middle stages of their careers, which, given the shortage of medical personnel caused by the pandemic, leads to highly negative consequences (Ehrlich et al., 2020). Scholarship implies influence at all stages of nursing: from their education to specific practical cases through the prism of theory, data analysis, and methodological development (American Association of Colleges of Nursing, 2021). Competence also implies adherence to ethical standards, which are also critical in building a care plan for aggressive patients. The role of the DNP can be defined as exploratory: the problem still needs effective methods and approaches to ensure nurses mental safety and clinical interventions in building relationships with the patient.

Finally, quality and safety is another essential competency in the context of working with potentially violent mentally ill patients. This competence implies several theses. The first of these argue that quality and safety issues are dictated by the system and environment in which the nurse works with the patient, and any negative consequences result from the imperfection of the system and not of its individuals (American Association of Colleges of Nursing, 2021). Extrapolating this statement to work with potentially aggressive patients, one can note the imperfection of approaches and the absence of mandatory preventive mechanisms in the form of training or reminders, which is a drawback of the system, which loses personnel because of this. The second thesis implies the search for synergy between the patient and the nurse and the assessment of precisely the safety criterion. For this DSP, this criterion is the most important, and therefore deep knowledge of this particular competence is essential for nurses. The role of the DNP is to mitigate all known risks that may lead to burnout or other undesirable processes in a given context (Zaccagnini & Pechacek, 2021). Research in this area communicates with the discipline of risk management, seeking to reduce the possibility of their occurrence.

Indeed, the problem of diagnosing osteoporosis is critical for entire communities for several reasons. The cause of osteoporosis can be a long history of smoking, alcohol abuse, digestive problems, malfunctioning metabolism, or the disease is inherited. In old age, osteoporosis often occurs due to poor absorption of calcium, as well as nutrients in the intestines. In the first case, it is necessary to conduct health education about a healthy lifestyle through the prism of osteoporosis, which leads to highly negative consequences for the human body. The second is to diagnose it in advance and launch specific preventive mechanisms that promote bone health and reduce disease incidence in the population as a whole. Many people probably do not attach importance to bad habits in the context of their detrimental effect on the bones.

Conclusion

Consequently, the entire healthcare system with interprofessional interaction must minimize the risks in the early stages since, in the future, the implementation of dual-energy X-ray absorptiometry for patients is costly and challenging to implement. In addition, the pandemic has made adjustments with unprecedented disruptions in the work with patients with osteoporosis: many patients have lost qualified medical care due to restrictions, including social distancing (Yu et al., 2020). The optimization of systemic activity has become a sensitive issue that requires timely solutions to continue to reduce the incidence of osteoporosis and improve recovery rates in clinical practice. Since the problem requires a comprehensive solution at a sufficiently high level of responsibility, it is precisely systemic solutions on the part of medical institutions that are needed, not just improving efficiency on an individual basis. In this regard, I fully agree with Sarina regarding the chosen competencies from The Essentials and the potential role of DNP in solving and researching the problems of diagnosing osteoporosis and improving the treatment effectiveness.

References

American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. Web.

Drukker, M. (2021). Aggression on the psychiatric ward: Prevalence and risk factors. A systematic review of the literature. Plos One, 16(10), 1-34. =

Ehrlich, H., McKenney, M., & Elkbuli, A. (2020). Protecting our healthcare workers during the COVID-19 pandemic. The American Journal of Emergency Medicine, 38(7), 1527.

Yu, E. W., Tsourdi, E., Clarke, B. L., Bauer, D. C., & Drake, M. T. (2020). Osteoporosis management in the era of COVID19. Journal of Bone and Mineral Research, 35(6), 1009-1013.

Zaccagnini, M., & Pechacek, J. M. (2021). The doctor of nursing practice essentials: A new model for advanced practice nursing. Jones & Bartlett Learning.

Considering patient care and business, the provision of telemedicine services is more appropriate compared to opening a retail clinic. Firstly, technology-mediated care and patient education services will drastically increase the networks outreach, promoting better healthcare in remote areas. Secondly, the effectiveness of small retail clinics in reducing the workload on ED departments is non-existent, whereas telemedicine can be helpful in this regard.

Research Evidence Supporting the Decision

Current studies do not compare telemedicine and retail clinics directly, but research evidence favors the formers higher effectiveness in preventing high-risk conditions. Martsolf et al. (2017) report that patients access to retail clinics for the treatment of non-serious disorders does not reduce the rate of low-acuity ED visits in these areas. In pediatric care contexts, telemedicine visits are as effective as conventional visits in preventing subsequent hospital or ED admissions (Joshi et al., 2021). Additionally, high-intensity telemedicine interventions in geriatric populations can decrease dementia patients ED visits by more than 20% (Gillespie et al., 2019).

Cost Control Considerations

The project supports cost control by promoting cost savings for the healthcare system. Telemedicine use in ICU, pediatric services, and dermatology can reduce service costs and patient travel costs by 56% and 94%, respectively (Atmojo et al., 2020). Additionally, telemedicine services can lower hospitals document printing costs, thus allowing for wiser resource allocation decisions.

Possible Areas of Concern

During telemedicine implementation, the system should be mindful of risks. The system must ensure the adequacy of all physicians technical training and equipment management knowledge. Also, IT teams ability to offer timely assistance to care providers should be guaranteed. Finally, the limited interoperability of diverse locations patient record systems might create barriers to care continuity.

Conclusion/Recommendation

In summary, the system is recommended to add telemedicine to the list of available services. Doing so could facilitate patient surveillance and reduce ED visits while also optimizing care and administrative costs. Therefore, telemedicine can benefit the system both financially and reputationally.

References

Atmojo, J. T., Sudaryanto, W. T., Widiyanto, A., Ernawati, A. D., & Arradini, D. (2020). Telemedicine, cost effectiveness, and patient satisfaction: A systematic review.Journal of Health Policy and Management, 5(2), 103-107.

Gillespie, S. M., Wasserman, E. B., Wood, N. E., Wang, H., Dozier, A., Nelson, D., McKonnochie, K. M., & Shah, M. N. (2019). High-intensity telemedicine reduces emergency department use by older adults with dementia in senior living communities. Journal of the American Medical Directors Association, 20(8), 942-946.

Joshi, C., Jacobson, M., Lori, S., Shea, S., Yang, M., & Eschbach, K. (2021). Risk of admission to the emergency room/inpatient service after a neurology telemedicine visit during COVID-19 pandemic.Pediatric Neurology, 122, 15-19.

Martsolf, G., Fingar, K. R., Coffey, R., Kandrack, R., Charland, T., Eibner, C., Elixhauser, A., Steiner, C., & Mehrotra, A. (2017). Association between the opening of retail clinics and low-acuity emergency department visits.Annals of Emergency Medicine, 69(4), 397-403.

The immune system has specific mechanisms to protect human beings from pathogens. The primary components of an immune system include the bone marrow, the thymus, the spleen, the lymphatic system, antibodies, and white blood cells. The system has some particular chemicals, cells, and body parts that defend the body against infections (Ted-Ed, 2018). White blood cells are the most paramount because their main work is fighting diseases. The immune system is the principal safeguard of the body against diseases, illnesses, and infections.

According to the video, the extensive network comprises tissues, organs, and cells, which synchronize the defense mechanism of the body against toxins, viruses, and bacteria. The system can quickly pinpoint and destroy the disease-causing organisms when they enter the body before they can multiply and make a person sick. The white blood cells are the most prominent of the systems numerous components (Ted-Ed, 2018). The primary responsibility of the white blood cells is to fight microbes that are regarded as foreign to the body. The white blood cells are part of the lymphatic system and are primarily manufactured in the bone marrow.

Organisms such as bacteria and viruses are dangerous for the reason that they could make something as minor as a cold or a small cut fatal because of the underlying infections (Ted-Ed, 2018). The system relies solely on the millions of white blood cells, which act as the army against diseases and infections. White blood cells or leukocytes originate from the bone marrow and migrate to the lymphatic system and the bloodstream to carry out their work. There are 4,000 to 11,000 leukocytes in every microliter of blood. Leucocytes act like security personnel or an army of the body and constantly screen the blood tissues against harmful foreign matter.

References

Ted-Ed. (2018). How does your immune system work?-by Emma Bryce[Video]. YouTube. Web.

An unknown assailant sexually abused Gary on his way from school. He was taken to their local child support center for treatment who applied research methodologies and evaluation techniques to undertake and monitor the treatment progress. Intervention techniques applied resulted in the gradual psychological recovery of Gary. However, the treatment plan failed to consider possible post-traumatic stress disorder, common among victims of sexual assault (Mutavi & Mathai, 2017). Although the treatment plan abided by the laid-out rules and procedures, enlisting a male professional would have promoted Gary to open up sooner, decreasing his treatment duration. The boy would readily cooperate with a male social worker in telling his brother about the assault first and not his mother.

Key Client Outcomes and How the Outcomes were Measured

In the course of the treatment, the flashbacks gradually decreased after applying intervention techniques to the treatment. The child services professional measured the intervention success through the Generalized Contentment Scale (Betty, 2014). An in-depth revisit of the particular day of Garys assault brought back the gory memories. The rekindling of the assault memories was measured after the police asked Gary to explain the events of his assault later. Alternatively, during the intervention and before intervention marked significant differences in the outcome of the treatment. The last outcome involved mood changes after the intervention, where Gary began participating in various activities, and his enthusiasm increased in his daily activities.

How the Social Worker Used the Empowerment Approach in Collecting Data

She empowered Gary by applying intervention techniques such as environmental manipulation, psychoeducation, empathic listening and easing his feelings, relaxation, and self-talk, and reframing Garys involvement in the assault by depicting him as the victim (Betty, 2014). The empowerment approach methods boosted Garys self-esteem and eradicated the trauma, making him feel safe and active.

Evaluation to Measure the Effectiveness of the Food Stamped Challenge

The challenge should have lasted longer than one week to account for the health difference before and after enrolling on food stamps as their diet report was only a projection (Shira & Yoav, 2010). Shira and Yoav Potash would have carried out the challenge in a typical food stamp-reliant scenario. For instance, many people relying on food stamps are homeless, and some have difficulties covering miscellaneous costs such as cooking gas and electricity bills.

References

Potash, S., Potash, Y. (2010). Food Stamped [Film]. Summit Pictures.

Blythe, B. J. (2014). Evaluating the treatment of a sexually assaulted child. In C. W. LeCroy (Ed.), Case studies in social work practice (3rd ed., pp. 341-348). Wiley.

Mutavi, T., & Mathai, M. (2017).Post-traumatic stress disorder (PTSD) in sexually abused children and educational status in Kenya: A longitudinal study. PubMed Central (PMC).