Want help to write your Essay or Assignments? Click here
Health Promotion to Pregnant Women
Introduction
All expectant women should ensure that they stay healthy during pregnancy since most of what they consume is shared with the foetus. Some of the things women take are good for the baby while others can be harmful. To educate a group of first-time teenage mothers, I will use posters to inform them about the following important information.
First, I will emphasize on the need for pregnant women to maintain a balanced diet. Most meals should include starch –based foods such as cereals, rice, fruits as well as vegetables. Women should also eat a lot of fiber and proteins. Weight monitoring is also of great importance although it has been found out that a weight increase of between 11 to 16kg during pregnancy is normal.
Pregnant women also need an extra 200 calories especially in their last month of pregnancy. Rauh et al. (2013) support the idea that folic acid supplements are ideal during pregnancy and should be taken up to the end of the 12th week of pregnancy since they aid in avoiding anemia, a common condition among pregnant women.
Want help to write your Essay or Assignments? Click here
Tobacco smoke contains harmful chemicals that pass through our bloodstream and goes into the growing foetus’ blood. Therefore, the pregnant woman should be counseled to stop smoking and avoid risks such as ectopic pregnancy, miscarriage, and premature labor (Piano & Phillips, 2013).
Additionally, during pregnancy women should avoid drinking alcohol because it slows down growth and causes serious problems in future. Pregnant women should also avoid pets which at times may carry germs that can be passed to the unborn baby. For instance, toxoplasma is bacteria commonly found in cats, therefore, I will educate women to wash their hands after handling cats.
This will aid in minimizing the effects of these germs. Using any illicit drugs when pregnant can have a detrimental effect on the unborn baby. Illicit drugs in most cases cause birth defects or miscarriage. Drug use can also affect the baby central nervous system according to Simkin et al. (2016).
Conclusion
Pregnant women should seek advice to get more information on how to stay healthy during pregnancy and after giving birth. Lifestyle adjustments will enable both the mother and the baby to stay healthy.
Rauh, K., Gabriel, E., Kerschbaum, E., Schuster, T., von Kries, R., Amann-Gassner, U., & Hauner, H. (2013). Safety and efficacy of a lifestyle intervention for pregnant women to prevent excessive maternal weight gain: a cluster-randomized controlled trial. BMCpregnancy and childbirth, 13(1), 1.
Simkin, P., Whalley, J., Keppler, A., Durham, J., & Bolding, A. (2016). Pregnancy, childbirthand the newborn: The complete guide. Simon and Schuster.
Want help to write your Essay or Assignments? Click here
Want help to write your Essay or Assignments? Click here
Assisted Reproduction Technology
History of Assisted Reproduction Technology
In July 1983, the first successful human-human transfer of an embryo resulting in pregnancy was announced. Biggers and John report that the procedure took place at the Harbor-UCLA Medical Center under the supervision of Dr. John Buster. Subsequently, the first birth was reported in February 1984. It is estimated that between then and now, about 350,000-50,000 babies have been born following this procedure (Biggers and John 123).
The embryo was transferred from the woman in whom it was developing to another woman to the woman who gave birth 38 weeks after. Henceforth, this was considered milestone breakthrough for women who were infertile (Biggers and John 121). It has given light to embryo donation and the use of human oocyte as an alternative to adoption for these women.
The Uses and Benefits
According to Wagner, embryo transfer or assisted reproduction technology is used for women with infertility challenges such as, blocked and damaged oviducts or those whose fallopian tubes have been removed. Women with ovulation disorders can also take advantage of this technology. As well, it can also be utilized in case of men with male factor infertility (low sperm count or sperm immobility) and persons with genetic disorders (Wagner, Marsden, and Patricia 1028).
Same gender couples and individuals who choose to be single can also use this technology. The benefits that come with freezing of embryos include the ability to store them in case you are at risk of injury or death.it is important for persons who conditions that require medical attention, which affects their fertility (Wagner, Marsden, and Patricia 1028). Freezing of embryos is also beneficial people undergoing sex-change operations. Finally, it gives people a chance to become donors and assist individuals with infertility problems.
Want help to write your Essay or Assignments? Click here
Problems and Risks
The only known problem with embryo transfer surface when a donor who is not registered participates without the consent of Human Fertilization and Embryology Authority (HFEA) clinic. This compromises your health and that of the child because of lack of stringent screening and testing procedures (Wagner, Marsden, and Patricia 1030). Also, it becomes unclear on who is the legal parent of the child as this can allow the donor to take the legality. Furthermore, it will be impossible for this child to have any information of the donor since it will be missing in the HFEA files.
Apart from this, there are also several risks surrounding this technology (Wagner, Marsden, and Patricia 1028). As with other medical processes, fertility medications have side effects, which range from headaches, ovarian hyperstimulation syndrome breath shortness, and fainting. Additional risks include; bleeding and infections during egg retrieval, the chance of multiple pregnancies and associated psychological and emotional stress (Wagner, Marsden, and Patricia 1028).
Society Viewpoints
There are some social aspects outlined by (Schoolcraft et al. 863). Some people, especially in professional settings, are of the opinion that this technology should be left to same gender couples only. In Asian countries, it is only allowed for married couples only (Schoolcraft et al. 866). It widely practiced in European countries while it is prohibited in South America because of religious reasons (Schoolcraft et al. 867). This is because Christians consider this technology immoral. Other people argue that the stress and pain that come with this procedure can make difficult for the parent to bond with the child.
Personal Effect
This technology has no significant effect on me because from my perception people should be given a chance to choose the mode of reproduction they consider most favorable. It is therefore not under my jurisdiction to judge it as wrong or right (Schoolcraft et al. 864). It is, therefore, a matter of individual choice because it only involves the individuals who choose it.
Wagner, Marsden G, and Patricia A St Clair. “Are in-vitro fertilization and embryo transfer of Benefit to all?” The Lancet 334.8670 (2014): 1027-1030. Web. http://www.ncbi.nlm.nih.gov/pubmed/2572751
Want help to write your Essay or Assignments? Click here
Want help to write your Essay or Assignments? Click here
Chronic Asthma
Maslan & Mims (2014) define asthma as an inflammatory condition of the airway that arises due to hyperactivity to a stimuli causing obstruction of airflow, development of fatal exacerbations, and other respiratory complications. Some of the common allergens that have been citied to trigger asthma include mold spores, grass pollen, and animal dander. Medications such as aspirin, industrial materials such as toluene diisocynate, and indoor air pollution are other common triggers of asthma. Asthma can either be acute or chronic both having significant commonalities and differences.
Pathophysiology of Acute Asthma
Research has reported that exposure to inflammatory allergens triggers reactions in the respiratory system. For instance, Cardinale et al., (2013, March) reports that the onset of acute asthma involves an increased invasion of neutrophils into the respiratory system as well as tumor necrosis factor (TNF), mast cells, and eosinophils. These inflammatory mediators and cells cause increased secretion of respiratory mucous which in turn obstructs the airways, over-inflation of lungs, thickening of the basement membrane, and destruction of the epithelial membrane.
Narrowing of the airway limits inhalation and exhalation exercises of an individual. Consequently, a mismatch in the ventilation-perfusion ration arises. This means that an increase in deoxygenated blood occurs; an event that is quite fatal especially when quick medical attention is not sought.
Want help to write your Essay or Assignments? Click here
Pathophysiology of Chronic Asthma
Just like acute asthma, chronic asthma develops as a result of inflammation in the respiratory system. The allergens initiate the production of inflammatory mediators such as cytokines, histamines, and leukotrines (Maslan & Mims, 2014). These mediators trigger increased contraction and relaxation of the bronchial smooth muscles. Consequently, bouts of airway constriction develop generating the classic symptom of asthma; wheezing.
The narrowing hinders effective exhalation and inhalation. As a result, hypoxia develops and there is increased levels of carbon dioxide in the blood which affects important organs in the body especially the heart, brain, and the kidneys. A number of changes usually occur in patients suffering from chronic asthma. First, there is an increase in eosinophils in the blood supplying the respiratory system and thickening of the lamina reticularis.
The number of mucous secreting cells also increases as well as the size of the bronchial smooth muscles. If medical attention is not sought urgently, patients start presenting with lactic acidosis, hypercapnia, and an unproportional level in the acid-base level in the body. Moreover, in chronic asthma there is an increased degree of hyperactivity to stimuli and an irreversible loss of lung function due to remodeling of respiratory structures. Smooth muscle hypertrophy and hyperplasia are also common occurrences.
Risk Factor
According to Tai et al., (2014), age is one of the leading risk factor that has a significant impact on the pathophysiology of both chronic and acute asthma. Unlike adults, children are usually highly susceptible to suffering from both acute and chronic asthma. This is mainly because adults have cells that are more resistant to the inflammatory agents compared to children. Normally, adults who have previously been diagnosed with asthma can tolerate the condition for a number of weeks unlike children who can easily die within a short time after experiencing an asthma attack just as it is reported in the case of Dynasty Reese and Bradley Wilson.
It is for this reason that parents should be highly educated on the symptoms of asthma as well as the approaches they should undertake in the event a child presents with the symptoms. Moreover, parents should be enlightened about the risk factors of asthma and how they can safeguard their children from being exposed to the asthma triggers.
Diagnosis
For effective diagnosis of asthma, physicians begin by determining the chief complaint followed by the history of the presenting illness (HPI). Asthmatic patients usually complain about wheezing, coughing, tachypnea, shortness in breath just as it is reported in the case study of Dynasty Reese and Bradley Wilson. Spirometry has been tipped to be an effective approach in the diagnosis of asthma.
This technique is used in identifying the differential diagnosis by determining the FEVI of a patient. For instance, the test is positive for asthma when the FEV1 increases by about 12% while the FVC increases by about 200mL (Killeen & Skora, 2013). Chest X-rays can also be used in the diagnosis of asthma as well as the patient’s family history.
In management of asthma, patients are first given maintenance medications such as inhaled corticosteroids which include fluticasone and betamethasone. Rescue medications are then prescribed. They include bronchodilators such as salbutamol and levalbuterol. For adults with asthma, the most suitable medications are the anti-inflammatory agents such as inhaled steroids where as in children, oral medications like prednisone are recommended (Alexander et al., 2012).
References
Alexander, A. G., Barnes, P. J., Chung, K. F., Flower, R. J., Garland, L. G., Goldie, R. G., … & Lulich, K. M. (2012). Pharmacology of asthma (Vol. 98). Springer Science & Business Media.
Cardinale, F., Giordano, P., Chinellato, I., & Tesse, R. (2013, March). Respiratory epithelial imbalances in asthma pathophysiology. In Allergy and Asthma Proceedings (Vol. 34, No. 2, pp. 143-149). OceanSide Publications, Inc.
Killeen, K., & Skora, E. (2013). Pathophysiology, diagnosis, and clinical assessment of asthma in the adult. Nursing Clinics of North America, 48(1), 11-23.
Maslan, J., & Mims, J. W. (2014). What is asthma? Pathophysiology, demographics, and health care costs. Otolaryngologic Clinics of North America, 47(1), 13-22.
Tai, A., Tran, H., Roberts, M., Clarke, N., Gibson, A. M., Vidmar, S., … & Robertson, C. F. (2014). Outcomes of childhood asthma to the age of 50 years. Journal of Allergy and Clinical Immunology, 133(6), 1572-1578.
Want help to write your Essay or Assignments? Click here
Want help to write your Essay or Assignments? Click here
Mammary duct ectasis
Case study overview
A 60-year-old Latina female is concerned about the thick green discharge on her left breast, a situation she has experienced for the past month. The discharge happens spontaneously causing pain and burning around the breast. She reported to have breastfed all her children; she was not on any medication. However, occasionally she used Tylenol for treating arthritis.
The mammogram test done 14 months ago is within the normal limits. Physical examination indicates that there are slight redded and edematous around the left breast. A greenish-black is seen when palpation is done; there is an ovoid which is smooth, very mob that is not tender at 1cm nodule in the RUIQ at 11.00 5cm from the nipple. The patient is worried that she might be at risk of developing breast cancer.
Want help to write your Essay or Assignments? Click here
Diagnosis
Women over 50 years are likely to suffer from mammary duct ectasis; this is a condition that occurs when the breast dust becomes wider making its walls thicken causing fluid build-up around the breast (Stanford School of Medicine, 2016). Sticky and thick black or green discharge is an indication of mammary duct ectasis. In addition, the nearby tissues around the breast and the nipple will become tender and red. The hard lump caused by this condition is often confused with breast cancer (Patel, et al, 2015).
Treatment and management plan
The patient needs antibiotics for 10 to 14 days to treat the infection; pain medication includes acetaminophen or, ibuprofen, other drugs are Advil, Motrin IB among others. Acetaminophen is commonly prescribed to reduce the pain ,an adult dosage includes is 2 regular strength 325 mg after every four hours or 2 extra-strength of 500mg after every six hours but the maximum dosage should not exceed 4,000 mg in a day.
In mild cases, patients are advised to conduct warm compresses to help to manage the disease, however in severe cases, surgery will be recommended whereby an incision will be made at the edge of the colored tissue to release the built up fluids (Chougule et al, 2015).
Mammary duct ectasis is often confused with breast cancer, therefore women especially those that are above 50 years need to be educated about the differences in the presentation between the two conditions and urged to seek urgent medical attention whenever they have sysmptoms related to mammary duct ectasis.
References
Chougule ,A., Bal A, Das, A., Singh, G ( 2015). IgG4 related sclerosing mastitis: expanding the morphological spectrum of IgG4 related diseases. Pathology 47 (1): 27–33
Patel, B. K., Falcon, S., & Drukteinis, J. (2015). Management of nipple discharge and the associated imaging findings. The American journal of medicine, 128(4), 353-360.
Want help to write your Essay or Assignments? Click here
Maslan & Mims (2014) define asthma as an inflammatory condition of the airway that arises due to hyperactivity to a stimuli causing obstruction of airflow, development of fatal exacerbations, and other respiratory complications. Some of the common allergens that have been citied to trigger asthma include mold spores, grass pollen, and animal dander. Medications such as aspirin, industrial materials such as toluene diisocynate, and indoor air pollution are other common triggers of asthma. Asthma can either be acute or chronic both having significant commonalities and differences.
Pathophysiology of Acute Asthma
Research has reported that exposure to inflammatory allergens triggers reactions in the respiratory system. For instance, Cardinale et al., (2013, March) reports that the onset of acute asthma involves an increased invasion of neutrophils into the respiratory system as well as tumor necrosis factor (TNF), mast cells, and eosinophils. These inflammatory mediators and cells cause increased secretion of respiratory mucous which in turn obstructs the airways, over-inflation of lungs, thickening of the basement membrane, and destruction of the epithelial membrane.
Narrowing of the airway limits inhalation and exhalation exercises of an individual. Consequently, a mismatch in the ventilation-perfusion ration arises. This means that an increase in deoxygenated blood occurs; an event that is quite fatal especially when quick medical attention is not sought.
Pathophysiology of Chronic Asthma
Just like acute asthma, chronic asthma develops as a result of inflammation in the respiratory system. The allergens initiate the production of inflammatory mediators such as cytokines, histamines, and leukotrines (Maslan & Mims, 2014). These mediators trigger increased contraction and relaxation of the bronchial smooth muscles. Consequently, bouts of airway constriction develop generating the classic symptom of asthma; wheezing.
The narrowing hinders effective exhalation and inhalation. As a result, hypoxia develops and there is increased levels of carbon dioxide in the blood which affects important organs in the body especially the heart, brain, and the kidneys. A number of changes usually occur in patients suffering from chronic asthma. First, there is an increase in eosinophils in the blood supplying the respiratory system and thickening of the lamina reticularis.
The number of mucous secreting cells also increases as well as the size of the bronchial smooth muscles. If medical attention is not sought urgently, patients start presenting with lactic acidosis, hypercapnia, and an unproportional level in the acid-base level in the body. Moreover, in chronic asthma there is an increased degree of hyperactivity to stimuli and an irreversible loss of lung function due to remodeling of respiratory structures. Smooth muscle hypertrophy and hyperplasia are also common occurrences.
Want help to write your Essay or Assignments? Click here
Risk Factor
According to Tai et al., (2014), age is one of the leading risk factor that has a significant impact on the pathophysiology of both chronic and acute asthma. Unlike adults, children are usually highly susceptible to suffering from both acute and chronic asthma. This is mainly because adults have cells that are more resistant to the inflammatory agents compared to children.
Normally, adults who have previously been diagnosed can tolerate the condition for a number of weeks unlike children who can easily die within a short time after experiencing an asthma attack just as it is reported in the case of Dynasty Reese and Bradley Wilson. It is for this reason that parents should be highly educated on the symptoms as well as the approaches they should undertake in the event a child presents with the symptoms. Moreover, parents should be enlightened about the risk factors and how they can safeguard their children from being exposed to the triggers.
Diagnosis
For effective diagnosis, physicians begin by determining the chief complaint followed by the history of the presenting illness (HPI). Asthmatic patients usually complain about wheezing, coughing, tachypnea, shortness in breath just as it is reported in the case study of Dynasty Reese and Bradley Wilson. Spirometry has been tipped to be an effective approach in the diagnosis of an asthmatic patient.
This technique is used in identifying the differential diagnosis by determining the FEVI of a patient. For instance, the test is positive for asthma when the FEV1 increases by about 12% while the FVC increases by about 200mL (Killeen & Skora, 2013). Chest X-rays can also be used in the diagnosis, as well as the patient’s family history.
In management of the disease, patients are first given maintenance medications such as inhaled corticosteroids which include fluticasone and betamethasone. Rescue medications are then prescribed. They include bronchodilators such as salbutamol and levalbuterol. For adults, the most suitable medications are the anti-inflammatory agents such as inhaled steroids where as in children, oral medications like prednisone are recommended (Alexander et al., 2012).
References
Alexander, A. G., Barnes, P. J., Chung, K. F., Flower, R. J., Garland, L. G., Goldie, R. G., … & Lulich, K. M. (2012). Pharmacology of asthma (Vol. 98). Springer Science & Business Media.
Cardinale, F., Giordano, P., Chinellato, I., & Tesse, R. (2013, March). Respiratory epithelial imbalances in asthma pathophysiology. In Allergy and Asthma Proceedings (Vol. 34, No. 2, pp. 143-149). OceanSide Publications, Inc.
Killeen, K., & Skora, E. (2013). Pathophysiology, diagnosis, and clinical assessment of asthma in the adult. Nursing Clinics of North America, 48(1), 11-23.
Tai, A., Tran, H., Roberts, M., Clarke, N., Gibson, A. M., Vidmar, S., … & Robertson, C. F. (2014). Outcomes of childhood asthma to the age of 50 years. Journal of Allergy and Clinical Immunology, 133(6), 1572-1578.
Want help to write your Essay or Assignments? Click here
Want help to write your Essay or Assignments? Click here
VIRUSES
Virus Structures and Their Functions
All viruses are made of two main constituents, the nucleic acid genome, and the protein capsid. These structures create up the nucleocapsid but in animal viruses, the nucleocapsid has an additional structure called the lipid envelope (Zimmer, 2015). The genome can either be DNA or RNA but not both which may be single or double stranded. The function of the genome is to encode for proteins present on the protein coat/capsid.
The genome is also responsible for multiplication of the virus particle. The protein capsid covers the viral genome protecting it from nucleases and attaches the virus particle to specific receptors on prospective host cells during infection. The lipid envelope found in animal viruses, and it enables the virus to enter or exit host cells through endosomal membranes and protects the virus from the extracellular environment.
Diversity in Animal Viruses
The diversity of animal viruses is as a result of structural differences present in different viruses including the structure of the genome. Some viruses have DNA both single or double stranded as their genome; papillomavirus is a DNA virus which causes warts while others have RNA either single or double stranded an example is Influenza virus which causes the flu. Other viruses differ in their virus particle structure; some are icosahedral such as Adenovirus, others such as the rabies virus are helical or rod-shaped, while others are pleomorphic or irregular. Viruses can also be differentiated by the presence or absence of the lipid envelope, and based on this criteria animal viruses are classified into different families, for instance, the herpes simplex virus has an envelope while others do not (Villarreal, 2005).
Want help to write your Essay or Assignments? Click here
HIV Replication Cycle
The first stage of HIV replication is binding, where the virus enters the host immune cells by attaching its glycoproteins to the receptors on target cells (Murphy et al., 2012). After this attachment, the viral casing/envelope then fuses with the membrane of the host cell and releases its capsid into the cell in the process. Once the virus has bound to the target cell, its genome and enzymes, such as reverse transcriptase, integrase, rib nucleases, and protease, are injected into the cell (Murphy et al., 2012).
During the reverse transcription stage, the single-stranded viral RNA is then transcribed into complementary DNA by the enzyme reverse transcriptase. The cDNA and its complement are transported to the cell nucleus as double-stranded DNA and is integrated into a host chromosome by the enzyme integrase. This is referred to as the integration stage. The fourth stage is the transcription step where provirus is transcribed into RNA, which undergoes RNA splicing to form mRNAs (Zimmer, 2015). The mRNAs are the translated into regulatory proteins, and this takes place in the cytoplasm. These proteins are packaged into new virus particles.
Structural Differences and Similarities between PRPc and PrPSc
The main difference between the two prion forms is that PRPc has various amino acids and one disulphide bond giving them an alpha helical structure while PrPSc has a higher β-sheet structure. They are also different in solubility, fibril formation, and other features. There are no obvious similarities in structure between the two forms (Zimmer 2015). The function of the normal prion is controversial because present information indicates many different roles. Normal Function of Pro-Oncogenes
Proto-oncogenes code for proteins that control cell development and differentiation. They also play a role in signal transduction and passage of mitogenic signals (Berns, 2013). Viruses are known to cause tumor development when they integrate close to proto-oncogenes. The nearby integration of viral sequences genetically alters the proto-oncogene causing its RNA to cause cancerous tumor growth (Berns, 2013). Some oncogenic viruses include hepatitis c virus that causes 22% of liver cancers, human papilloma virus that causes cervical and vulvar cancers (Zimmer, 2015).
How Viruses Cause Disease
Viruses can reside in cells without causing any harm. However, when they start dividing inside the host cell, they breach its walls, and this triggers the activity of the immune cells. They invade the host cells and takes over the activities taking part inside the host cells. The virus continues to replicate until it fills up the host cell. At this stage, the host lyses releasing the viral particles which start infecting other cells repeating the replication pattern (Villarrealal, 2005).By this tyme, the host immune cells recognise the antigen and starts fighting and blocking the virus and establishes a disease.
References
Berns, K. I. (Ed.). (2013). The parvoviruses. Springer Science & Business Media.
Murphy, F. A., Fauquet, C. M., Bishop, D. H., Ghabrial, S. A., Jarvis, A., Martelli, G. P., … & Summers, M. D. (Eds.). (2012). Virus taxonomy: classification and nomenclature of viruses (Vol. 10). Springer Science & Business Media.
Villarreal, L. P. (2005). Viruses and the Evolution of Life. American Society of Microbiology.
Want help to write your Essay or Assignments? Click here
HPV Vaccine: Barriers and Mitigation
According to the Center for Disease Control (2012), the HPV vaccine has over 97% effectives in preventing cervical cancer cases in the globe. There is need for using the vaccine and convincing stakeholders to fully integrate its use in the community because of high levels of sexual activity among preteens and adults.
The stakeholders for the project are Hispanic pediatrics aged 10 to 13 years and their parents who would serve as advocates and champions of the vaccine. This section of the HPV vaccine based project will discuss the potential barriers to the implementation of the project. The stakeholders are likely to pose a challenge in the intended wide vaccination of preteens, thereby posing a need to addressing and preventing those barriers.
The stakeholders might hold insufficient information about HPV and therefore not know about the existing risks that are already posed by the pathogen. Such parents or guardians are also likely to be unaware of the wide prevalence of the disease, and therefore, the risks that it poses to their children’s health (Caitlin, Escoffery, Satsangi & Brownstein, 2015).
Want help to write your Essay or Assignments? Click here
The project will consider an education program that gives talks about the causes, transmission and prevention methods that can be used in fighting the Human Papilloma Virus. The project will involve Spanish speaking volunteers that can integrate Hispanic values into the dispensation of information about the condition (Butts, Janie, and Rich, 2010). The project will also enlist the assistance of religious organizations, politicians, local celebrities, and community centers. One of the reasons why HPV is highly prevalent is the low manifestation of symptoms among those that are infected.
Therefore, those that are infected are likely to infect a high number of partners especially if they do not practice safe sex. HPV poses the threat of causing cervical cancer which might be difficult to treat if it is detected late. If this information is dispensed through the correct avenues, it might contribute to the mobilization of the Hispanic parents (stakeholders) to allow their children to be vaccinated with the HPV vaccine.
Want help to write your Essay or Assignments? Click here
Gastrointestinal disorders
Various gastrointestinal disorders may present with similar symptoms which may make the diagnosis difficult especially when the information provided in the patient history is not sufficient. In the case study presented, the patient presents with the symptoms of weight loss, anorexia, epigastric tenderness, and chronic heartburn. From the information garnered from the patient history, the risk factors included the use of NSAIDS and smoking.
Apart from peptic ulcer disease, gastroesophageal reflux disease, and gastric cancer, the differential diagnosis would include other conditions such as abdominal pain syndrome as well as dyspepsia (Agarwal & Mayer, 2013). The definite diagnosis is difficult to make since the patient did not provide sufficient information regarding the disorder.
For instance, the health care professional ought to ask the patient of the history of the occurrence of such a condition in members of the immediate family so as to rule out any genetic predisposition to the disorder (Agarwal & Mayer, 2013). Also, it would have been important if the patient was asked about having taken opioids or any other related drugs (Talley & Ford, 2015).
Want help to write your Essay or Assignments? Click here
Again it is important that various tests such as imaging tests be taken on the patients to assist in making the definitive diagnosis (Talley & Ford, 2015). Some further tests that should have been done include virtual colonoscopy and computed tomography to examine the patient intensively for any conditions that could have been causing the disorder. Also, magnetic resonance imaging could also have been used to rule out the possibility of the patient having any malignancies within the gastrointestinal system (Agarwal & Mayer, 2013).
More so it is recommended that endoscopy is conducted on the patient to determine or rule out the occurrence of peptic ulcer disease (Talley & Ford, 2015). Additionally, blood tests should be carried out on the patients to determine if they are suffering from the narcotic bowel syndrome.
References
Agarwal, S., & Mayer, L. (2013). Diagnosis and treatment of gastrointestinal disorders in patients with primary immunodeficiency. Clinical Gastroenterology and Hepatology, 11(9), 1050-1063.
Want help to write your Essay or Assignments? Click here
OBESITY: Community Health and Population focused Nursing
Identify a community for which there is data available that will support the diagnosis
The county is located in Pennsyltucky-in the northern region of the State. The region is mountainous and is characterized by stone mining industry. The region experiences warm and humid summer and heavy instant snow falls during winter. The region lies in York County. The region has diverse ethnic community owing to the large immigration of people from Gotham city. The community assessed was my county state which was among was one of the hardest hit by the 1919 influenza pandemic. Since then, the State has established adequate measures to ensure that such incidences do not occur again.
The main non-communicable health problem identified in this region is obesity. Obesity has serious consequences on the residents of this county’s health as well as the economy. This is because obesity is associated with a number of chronic health complications such as stroke, diabetes, cancer, and coronary heart disease. In the USA, obesity accounts for 147 billion dollars of the total health cost. Most people in this county are have adopted unhealthy lifestyles such as poor diet and physical inactiveness (CDC, 2016).
B. Health needs assessments
Population Economic Status
The demographic data released by the Census Bureau in, York County has a population of 438,052. The county reports 0.7% of the population change. The population density is estimated to be 484 per square meter. The median age is reported to be 40.6. Approximately, 70% of the populations are in the family. The unemployed in this region is about 4.7%. The employment growth rate is less than 1%. The income per capita in this community is estimated to be $ 27,996 (York County PA, 2016).
Disaster Assessment and Planning
The County is prepared for management of disasters. The York County office of Emergency Management (EOM) is responsible for the Emergency management program. The mission of the office is to protect the community by integrating necessary activities that sustain and improve their ability to mitigate, prepare and respond to the threatened natural disasters they ensure that the community are notified of emergency situation (York County PA, 2016).
Neighborhood/Community Safety Inventory
The main risk of concern of the County is caves and sinkholes and the severe winters which make it not favorable for the outdoor activities (York County PA, 2016).
Cultural Assessment
The culture and history of this county is unmatched in the country. The area is neighbored by super historic sites with an impressive ethnic population. The big cities in the county comprises of Italian, Irish, Chines among other immigrant communities. This is complemented by the rural lifestyles where most of the people in the mix of Amish which adds wild austerity to the culture (York County PA, 2016).
Windshield Survey
The homes are mainly detached and well maintained. The in-town homes yards are smaller as compared to township hopes. The roads are generally is in good condition to serve the business in the region. The main health concerns are that some roads are busier which an issue for physical activities such as cycling and walking along the path. This is due to the inadequate maintenance of the pedestrian paths, which can be used by the community to walk or cycle to their work places.
There are also high reports of injuries associated with car accidents. The parks are poorly maintained and I noticed several sink holes that have not been covered. This is makes it difficult for the residents to engage in outdoor activities. In addition, there are fewer green grocery shops. Therefore, most of the residents rely on fast foods because they are cheap and easily available. There is a big contrast of York County, Pa when compared with the neighboring counties as they have a nice climate and environment place to work and live.
SCAVENGER HUNT
The following six facilities were explored, Health department, YMCA, Fire department, American Red Cross, National Alliance on Mental illness, and community Center. The public health departments include Health department. This organizations target the residents of York County Community. The facilities advertise themselves through public facilities such as health centers and educational facilities. The main barriers observed are inadequate medical cover and Language barriers.
There is no service fee as these services are funded by the Local government. The staffs in these facilities are welcoming and very respectful. They are always ready to help. The main issue I observed is language barrier. Only few of the staff could speak other languages fluently, which makes it difficult for them to communicate with Non- English speaking residents. The organizations operate in both referrals and self-referrals process. The organization has details in internet and any person can access information from any location (Health York County, 2015).
American Red Cross this organizations target the residents of Central Pennsylvania. It serves 22 counties including the York County Community. The facilities advertise themselves through public facilities and the internet. It offers relief during pandemic and also facilitates blood donation processes. There are no barriers I observed in this organization as it helps every person of the society.
This organization obtains its funds from the Federal government. It is actively involved during natural disasters of disease pandemic. In fact, the organization responded to 520 disasters in the Central Pennsylvania region, where it helped 803 local families who had been affected by disaster. There is no service fee required for one to obtain help from this organization as it is funded by government and international bodies. Most of the staff I interacted with were respectful and had positive attitude.
In addition, the organization has five staff members who could speak other languages fluently, which makes it easy for them to communicate with Non- English speaking residents during disaster. The organizations operate in both referrals and self-referrals process. The organization has all contact details in internet (its website) and any person can access information from any location (Health York County, 2015).
NAMI York County branch offers support to people with mental illness in York County. The group offers support connection group that meets weekly and monthly. They also offer peer to peer and family to family education program that focusses on wellness, recovery and mental health. The facilities advertise themselves through public facilities such as health centers and educational facilities. The main barriers observed low awareness of the program in the community.
According to the director, most people in this community will not bring their loved ones to the organization because they fear discrimination. There is no service fee as these services are funded by the Local government, yet only a small fraction of the community enjoys the services. The staffs in these facilities are understanding, respectful and are always willing to help. Only few of the staff could speak other languages fluently, which makes it difficult for them to communicate with Non- English speaking residents or the deaf and dump. The organizations operate in both referrals and self-referrals process (Health York County, 2015).
The YMCA organizations target the residents of York County Community. This program offers health and fitness knowledge. The organizations operate in both referrals and self-referrals process. The organization works with people of all interests, abilities and ages. The organization tailors the programs content to suit the client needs. The facilities advertise themselves through its website.
The main barriers observed are that the organization charges $30-$49 for membership. This implies that large fractions of the population are locked out from experiencing these services. Language barriers are also an issue. Only few of the staff could speak other languages fluently, which makes it difficult for them to communicate with Non- English speaking residents. The staffs in these facilities are respectful, but tend to favor members from high income household.
Fire department provides professional, effective and courteous emergency response in order to protect the lives of York County residents as well as their visitors. The organization takes every effort to reduce the risk of the people residing in the community by preventing fire incidences through education and risk assessment of fire investigation. The department comprises of 56 personnel, one civilian employee and over 45 volunteers. There is no membership fee as it is funded by the federal government. The organization works mainly through referrals and self-referrals (Health York County, 2015).
Community center main role is health promotion of the York county residents. They do so by promoting various activities that people learn more about physical activity and good nutrition. They organize school based tournament and cultural weeks from which the community actively participate. However, only few community centers are operational so far. For this reason, most people in the rural areas rely on alternative medicines, and pregnant mothers deliver with the assistance of the house wives (Health York County, 2015).
Provide a logical interpretation of the collected data using concepts of epidemiology
York County is one of the most obese counties in the UDA. The current obesity rates in this county are approximately 31%. This indicates that approximately a quarter of the residents are obese. According to the distributed sources, the normal aggregate costs identified with the visits particularly to the obesity related outpatient and inpatient visits are estimated to be US$ 156 and US$ 1,512 respectively. Direct medicinal costs are estimated to be 45%-70% of the aggregate expenses linked to the obesity outpatient and inpatient visits. There are minimal reports with regards to the mortality and morbidity rates among the population in relation to obesity and its associated health complication (Health York County, 2015).
Identify any problems based on the Healthy People 2020 goals for the selected community.
In view of Healthy individuals 2020, there are problems affecting the selected community. These problems include lack of physical and social environments that facilitates promotion of good health, lack of adequate frameworks that will promote the development of healthy behaviors which aims at improving the residents quality of life and there lacks strategies that adequately help achieve health equity in this community implying that no measures have been successful in eliminating health disparities (Health York County, 2015).
Want help to write your Essay or Assignments? Click here
Provide a logical discussion of the problems in relation to the Healthy People 2020 goals
Arguably, York County is one of the weak links of global preparedness with regards to the management of obesity and associated chronic health complication. To begin with, there is no transparency in acknowledging the burden of obesity in the community. In addition, the public healthcare system has failed to establish systems that will ensure elimination of health disparities in the region. York County is one of the Counties in which obesity rates among the low income household is continuing to rise. The behavioral risk indicator indicates that the residents in this community hardly exercise. Only a third of the populations eat three servings of vegetables each day. The data also indicates that one in five people in the community are smoke (Healthy People 2020, n.d.).
Research findings indicate that two in every three people are obese. The rates of other chronic condition are such as cardiovascular disease, cancer, and diabetes also comparatively high. In addition, one in every five people in this community is diagnosed with depressive disorder and anxiety. Consequently, this has a negative impact on the Healthy People 2020 strategies whose main aim is to realize longer lives that are free from preventable diseases, elimination of health disparities, and creation of safe social and physical environments that promote good health and behavior of the healthy people (Healthy People 2020, n.d.).
Provide a logical discussion of community resources that are available to address the selected problem
CDC ACHIEVE Program
Community resources such as CDC ACHIEVE Program give valuable information effective strategies to manage obesity and its associated disorders. As mentioned therein above, people who are at risk of being obese infants, elderly, people suffering from chronic diseases, and pregnant women due to aggravating factors such as poverty and lack of physical activeness. This institution helps to increase awareness of the role of proper nutrition and physical activeness in eradicating obesity and its associated complication.
The strategies include funding the local governments to give them support to improve amenities including Heritage Rail Trail County Park, walking paths and bike routes. This aims at giving the pedestrians access to activities that will improve their health. The program also works with the other stakeholders including schools facility which plays a critical role in school food based programs. Other stakeholders involved includes fitness based programs and organization such as YMCA and YWCA. This helps the community to understand their perceived threats as well as the preventive measures that must be undertaken (Payne et al. 2013).
CDC ACHIEVE Program also helps the National Societies to play a leading role in managing the effects of the pandemic. This is facilitated through the close connection to communities and their auxiliary role to the governments through a measure commonly referred to as “Eat Play Breathe York”. This improves delivery of preventive services such as personal protective clothing during the outbreak, procurements and dispatchment of disinfectants, creating awareness sessions at school level (CDC, 2015).
Provide a logical primary prevention topic based on the problem identified in part C2.
Effective treatment of obesity begins with change in a person’s lifestyle. The obese person is expected to self-monitor the calorie intake and physical activities. This is achieved through effective goal setting and ensuring that they avoid factors that would lead to relapse of the old unhealthy habits. Effective management requires highly motivated patient and committed healthcare professionals including dieticians, physical therapists, psychologists and other subspecialists (Payne et al. 2013).
Behavior modification that targets diet and exercise must be included in all obesity management strategies for individuals whose BMI is above 25 kg/m2. Pharmacotherapy strategies are recommended for people whose BMI is above 27 kg/m2. Bariatric surgery is recommended for individuals who have BMI between 30 kg/m2 and 35 kg/m2. In dietary behavioral changes, people are advised to eat low calorie diets and practice portion control of the diets. Most of the diets underlie the weight programs guidelines such as those advocated by Jenny Craig and Weight watchers. The basic premise involves ensuring that the person obtain detailed dietary inventory which is normally used to estimate their caloric intake (CDC, 2015).
It has also been hypothesized that taking water before each meal facilitates weigh loss in obese middle aged people. This is associated to increase in resting energy due to water induced.
Physical activeness is recommended as it is effective for patients with cardiovascular disorder and respiratory health issues. Exercises are important because they help burn the excess body fat. For effective observation, people are encouraged to have moderate exercises continuously in order to achieve the effective weight loss. Research indicates that shorter bouts of physical activeness have better outcomes (Health York County, 2015).
