Nursing Assignment Example | Topics and Well Written Essays - 500 words - 14

Nursing - Assignment Example The article did bring out the role of public health department in the health of the community. Some of the activities of the activities of these nurses to the community outlined in the article include control of communicable diseases, administration of immunization, prevention of chronic diseases, family planning awareness and provision of safe food and drinking water to persons affected (Carolyn & Karen, 2011). The article clearly outlines the ability and potentials possessed by these groups of health workers. Public health nurses in the community based in creates safety networking by with other community agencies, identify risks affecting the community and intervene to provide solutions where possible, provision of health education especially to vulnerable population, and identify the problem and provide solutions before the problem advances. The author brought out challenges facing these groups of workers in the course of delivering their services, which affects effectiveness and fulfillment of their role. Lack of job security and inadequate staffing emerged as the serious problems affecting them. The author’s conclusion on the issue of public health nurses indicate that there are adequate resources and facilities are provided for effective service delivery and effective utilization of resources (Carolyn & Karen, 2011). The article managed to bring out and clearly demonstrates the striking issues affecting public health nurses and the efforts instilled to solve these issues, imposition of cost effective systems for disease prevention and health improvement of the community’s health. Having knowledge and understanding about the community is significant for health nurses, since policy makers and health planners when dealing with matters affecting the community will use the information. Community involvement by these groups of persons in meeting their welfare and ensuring that the needs of the community are met is an issue to

Nursing - Pain Management Essay Example | Topics and Well Written Essays - 1500 words

Nursing - Pain Management - Essay Example Cyclooxygenases Prostaglandin endoperoxide H synthase (commonly known as Cyclooxygenases) was purified in 1976 and cloned in 1988. This enzyme is the key catalytic protein in the synthesis of prostaglandins from arachidonic acid, resulting in pain and inflammation, and is subject to inhibition by non ­steroidal anti-inflammatory drugs (NSAIDS). In 1991, several laboratories identified a second gene product with COX activity, now termed COX-2. It is clear now that both isoforms, COX-l and COX-2 are expressed in both peripheral tissues and several areas of the CNS (Prochazkova et al., 2006). Theories of Pain Gatchel, Polatin, and Kinney (1995) state that there are two prominent theories of pain: the traditional specificity theory of pain and the gate control theory of pain. The former, still widely taught, proposes that pain is a specific sensation and that the intensity of pain is proportional to the extent of tissue damage. This theory implies a fixed, straight-through transmission system from somatic pain receptors to a pain center in the brain (p.416). In 1965, Melzack and Wall proposed the gate control theory. This theory suggests that there are physiological and neural mechanisms in the body that can have an effect on the perception of the painful stimulus (Hawthorn & Redmond 2001). The theory postulates that there are two controls that affect the gate. ... This gating mechanism depends on the relative quantity of information being received over the larger fibers versus the smaller fibers. In essence, the two peripheral impulses interfere with each other to alter pain perception. The gate control theory has received the most recognition in the field of pain research (Gatchel, Polatin, and Kinney 416). Anatomy & Physiology The complexities associated with the experience of pain are immense. Hall (1994) addresses those that deal with the physiological aspects by observing that medical science has not fully explained pain mechanisms. The specialization of receptors has been discovered. This refers to receptors being more sensitive to one stimulus than others. Hall (1994) continues with the identification of the receptor that is "incriminated" in the reception of pain, the unmyelinated or thinly myelinated nerve ending, an "unencapsulated" nerve ending. Hall describes the myelin sheath covering that encloses nerve fibers. The thickness of t his sheath varies throughout the body, from none in the periphery, to very thick where nerves enter bones, and other parts of the body. The covering acts as insulation to keep stimuli from entering the nerve from regions other than those served by the nerve (p. 11). Hall (1994) goes on to describe the receptor as a "primitive unorganized nerve ending and often has a weed-like appearance. It has many branches and overlaps with other receptors to totally cover the area which it serves" (p. 11). The area that a particular nerve serves is called a dermatome, which may serve an area of skin, a muscle, or any organ of the body. Hall states, "It is important to realize that the strength of stimulus is a critical factor in the production of pain in this and other

Political Science Research Paper Example | Topics and Well Written Essays - 500 words

Political Science - Research Paper Example From the study it is clear that Charles E. Schumer became a leader who finds common sense solutions to national issues. Moreover, Schumer has built a reputation for tirelessly fighting for New York by visiting all the 62 counties each year while talking to constituents on emerging issues and finding solutions. In practicing some of his policies and implementation, on March 16, 2015, Schumer blasted the current amendments by the federal department of housing and urban development of withdraw of federal funds promised to change housing units of towns and communities around New York City. This paper concerns the federal department which promised to change local infrastructure developments in the city to march with the current economic requirements on housing. Schumer policies on national development enabled him face the federal government and insisted on development that the national government and the federal government had earlier promised communities and towns within New York City. Schumer believes in reaching people and working with then through consultations to enable development. The federal government was to bring change to the towns of Elbridge, Skaneateles, and Onondaga, which he consistently pushed for the changes the federal government had earlier promised. The federal government approved CDBG funds within the communities in September 2014 and instead it became reluctant about the development. Schumer believes in transparency and accountability of the government in accomplishing some of their duties promised to the natives.

PI Darren Aronofsky 1998 Essay Example | Topics and Well Written Essays - 500 words

PI Darren Aronofsky 1998 - Essay Example This paper will discuss question number one of the instructions stated that is a central theme that suggests looking at the ‘face of God’ can only be done by verbalizing a string of numbers. A central theme in the film which discusses the face of God is the theme of Kabbalah. Kabbalah refers to an esoteric discipline, method or school of thought (Huntley 1). Sean Gullette, in Pi, acts as Maximillian Cohen. He is a paranoid mathematician looking for a number to unchain the patterns set up in nature. Max uses his homemade PC named "Euclid" to investigate these arithmetical patterns. The 216-letter phrase of God sought by the actors of the film refers to as the Explicit Name or the Shem ha-Meforash (Huntley 1). The name comes from the book Exodus 14:19-21. Each of these three bible verses is composed of 72 letters in traditional Hebrew. According to the film, if a person writes these verses in boustrophedon form, then the person gets 72 columns of 3 letter names of God (Huntley 1). Boustrophedon form means that one verse is above the other, the first from right to left. Then the second verse is from left to right and the third is from right to left. The nature of the Divine, according to Pi, prompted kabbalists to foresee two aspects of God. The first aspect is that God is totally unknowable, transcendent, limitless and simple. The second aspect is that God’s manifestation revealed his persona of which He creates and aids mankind (Huntley 1). The film speaks of the first as Ein/Ayn Sof, which means that God that literary has no limits. Of the unfriendly Ein Sof, nothing can be understood. The second feature of Divine emanations, nevertheless, are available to human awareness, vigorously interacting throughout physical and spiritual existence, reveal God immanently, and are tied up in the life of humans (Huntley 1).  

Mary Magdalene Essay Example for Free

Mary Magdalene Essay Do you know who i am? are you not attracted to my beauty? Many lovers have come and gone through my life. but a lot of people hate me. They say i am an adulterous woman. They say i have seven demons in my body. I hate this kind of life, you know. Nobody really loves me, and the burden of my sin is heavy upon me. I am Mary of Magdala. Just call me Mary Magdalene. I am in search of true love and acceptance. But who will ever love a sinner such as I? (walks sideways and to the center of the stage) Jesus I heard that a certain jesus has come to our town. He was healing the sick ones, and calling the sinners to repentance. Who is this man that He would even proclaim forgiveness for the sins of many? I must see Jesus! He must have answers to my questions! One day, a Pharisee named Simon hosted a feast and Jesus was one of the invited guests. I will not miss the chance to meet Jesus. I will prepare myself for the feast. (Mary removes the beads on her head, wears a veil and got ready with an alabaster flask of perfume) With this alabaster flask of perfume, I will annoint Jesus feet. (Many tries to see from afar the crowd at Simons place) Oh! There is a big crowd in Simons house. How could I possibly get inside? Oh, Ill wait until Jesus enters. By then, the crowd at the gate wil be ushered in. There is Jesus sitting near the host Simon. I tried to inch my way through the crowd until I finally knelt down at His feet. I wasted no time to pour the ointment on His feet and I wipe His feet with my hair. Then with a gentle voice he said to me, Woman, your sins are forgiven, your faith has saved you, go in peace. My heart rejoiced as I went away. The burden of my sins rolled away. Now Im free to obey Him. The next time I saw Jesus, He was haning on the cross, crucified between two thieves. My heart was crushed with grief. Who has done this crime? Who killed my Jesus? Can anybody tell me? Who killed Jesus? Was it the Hebrew children? A while ago, they were shouting: Crucify Hiim, (pause), crucify Him, crucify Him! Was it Pontius Pilate? he was the Governor who gave permission for His crucifixion. Was it the Roman soldiers? Torture of criminals is part of their profession. But Jesus wasnt a criminal! He was a sinless man. Who killed Jesus? Now its plain to see. It was really me! My sins! He died for my sins! Jesus, thank You for forgiving me at such a great price.

Personal Responsibility Essay Example for Free

Personal Responsibility Essay Task Personal Responsibility Thesis Rough Draft Many people have different complex ideas of what the definition of personal responsibility is, I feel mine is simple. My definition of personal responsibility is, when someone takes accountability for their obligations. To me this means that if someone accepts to do a particular project or assignment they are responsible and accountable to make sure it gets done. College success very closely relates to personal responsibility in that, in order to be successful in college you have to take personal responsibility to complete your assignments and courses on time in order to graduate when you are scheduled to. I am going to put aside time each night and find a spot in my house where I can study without distractions to complete my course work on time. To be specific, having personal responsibility means you have to be accountable for your actions. When people are holding themselves accountable for their actions they tend to work harder to complete the task correctly. They also will be certain to turn it in when it is due. Another part of the equation is taking responsibility for yourself. Being responsible means you do your assignments on time. It also means you did them correctly. By being responsible you show others you can be depended upon to fulfill your part of the task. The final portion of my definition is feeling a sense of accomplishment. Finishing a task on time and correctly gives a person a great sense of accomplishment. Being able to contribute to the team goals and be acknowledged for it makes a person feel good. I know I take a sense of pride when I am able to accomplish something I’ve been tasked with and finish it to the best of my ability and the rest of the team is happy with my efforts. In conclusion, although some people rather let others handle things, people need to be accountable for their actions for three main reasons. First, if people keep themselves accountable they will do a better job and complete their tasks on time. Second, it gives a person a sense of accomplishment and they feel good about themselves. But most importantly, it shows the other members on the team that they will do their part and can be relied and depended upon and complete their portion of the work.

Pancreatitis: Causes and Symptoms

Pancreatitis: Causes and Symptoms Acute Pancreatitis Introduction Pancreatitis is inflammation of the pancreas. It is widely accepted that it is caused by pancreatic enzymes digesting their own gland. This leads to inflammation of the pancreas. There are two main forms of pancreatitis, acute and chronic. In acute pancreatitis the pancreas can usually heal itself without any lasting changes to function or structure of the gland. If the pancreas heals but then inflammation reoccurs intermittently and causes irreversible changes to structure and function then it is known as chronic pancreatitis (1). Pathophysiology The exact mechanism is not fully understood however it is believed that the initial events take place within the acinar cells of the pancreas. Injury of the acinar cells leads to an inflammatory reaction localized within the cells. If this inflammation is excessive it can lead to a systemic inflammatory response. The inflammatory process can cause systemic effects because of the presence of cytokines, such as bradykinins and phospholipase A. These cytokines may cause vasodilation, increase in vascular permeability, pain, and leukocyte accumulation in the vessel walls all leading to inflammation. Fat necrosis may also occur causing hypocalcaemia; and pancreatic B-cell injury leading to hyperglycemia (2). A marked systemic inflammatory reaction can lead to ‘distant organ damage and multiple organ dysfunction syndrome (MODS) (1). This is the primary cause of morbidity and mortality in acute pancreatitis. The disease progression can be seen in the following three steps: 1) Local inï ¬â€šammation of the pancreas, 2) A generalized inï ¬â€šammatory response, 3) Multi-organ dysfunction (1) When there is injury or disruption of the pancreatic acini pancreatic enzymes namely trypsin, chymotrypsin and elastase leak into the pancreatic tissue. These enzymes become activated and initiate autodigestion and lead to acute pancreatitis. The activated enzymes break down the pancreatic tissue and cell membranes which leads to oedema, and vascular damage which leads to hemorrhage and necrosis. Some patients who have had a severe attack of pancreatitis who survive through the initial event die following a rather minor insult that would not be life threatening normally. It is said that the two hit hypothesis comes in to play here. The initial excessive systemic inflammatory response primes the immune system so that if another event takes place (a small insult in comparison) for example a chest infection, the immune system is overwhelmed leading to an exaggerated inflammatory response which can lead to death (1). History and examination The main presentation of acute pancreatitis is epigastric pain or right upper quadrant pain radiating through to the back. In many patients sitting forward can relieve the pain a little. The patient would usually also complain of nausea, vomiting and fever. It is important to note a history of previous biliary colic and binge alcohol consumption. The patient may also be tachycardic, tachypneic, hypotensive and mildly jaundiced (2). Abdominal tenderness, distension, guarding, and rigidity are quite common as are diminished or absent bowel sounds. If the inflammation should spread to the lungs then basilar rales may be noted on auscultation of the lung. In severe cases Grey Turner or Cullens sign may also be noted (2). Aetiology There are many causes of pancreatitis. The most common causes being habitual chronic alcohol consumption and biliary stones. In western countries including the UK alcohol abuse is the most common cause of acute pancreatitis. A recent study showed that 44% of patients have alcohol as the primary risk factor for acute or chronic pancreatitis (3). Gall stones can cause pancreatitis as they may become wedged in the pancreatic duct or ampulla of Vater and obstruct the pancreatic duct, leading to release of enzymes into the parenchyma. Other less common causes include: injury (e.g. post ERCP), drugs (such as NSAIDS, azathioprine), viruses (e.g. mumps), autoimmune conditions (e.g. SLE), hyperlipidaemia, malignancy and Scorpion and snake bites (4). Investigations to be done if pancreatitis is suspected 1) Serum enzyme levels: Serum amylase in pancreatitis is more than four times the normal value and lipase is twice the normal and this is diagnostic as there is no other source other than the pancreas, but this test is not always available (5). 2) Full blood count, U+E, glucose, CRP: the CRP value is significantly lower in drug-induced acute pancreatitis and a raised bilirubin and serum aminotransferase is suggestive of gall stones. Low serum calcium levels are quite common in acute pancreatitis and hypocalcaemia is also relatively common. 3) Plain erect abdominal x-ray: this is done to exclude other causes of the symptoms such as intestinal obstruction or perforation. 4) Chest x-ray: this can show if there is a rise in one hemidiaphragm, acute respiratory distress syndrome or pleural effusions which can occur in severe cases of acute pancreatitis. 5) CT with contrast enhancement: this can be diagnostic if clinical results were inconclusive. CT may show swelling, fluid collection and change in the density of the gland. 6) Ultrasound: this is useful to see if the pancreas is swollen and if the common bile duct is dilated. It can also detect gallstones (5). Management In mild cases management is on a general medical ward. Analgesia is given to relieve the pain, usually with pethidine. Morphine is not usually used as it can have a spastic effect on the sphincter of Oddi (4). The patient is given intravenous fluids and not allowed to take anything my mouth. If the patient is vomiting severely then a nasogastic tube is considered. Oral fluids and solids can be taken once symptoms have cleared and blood tests are normal. The cause must then be treated, for example if gallstones were the cause then they must be removed. The severity of pancreatitis is determined by the Glasgow score or Ranson criteria which looks at patient demographics, electrolytes and enzyme levels on admission and 48 hours later (see 1) Glasgow prognostic score Ransons criteria * Age >55 years * WBC >15 x109/l * Urea >16mmol/l * Glucose >10mmol/l * pO2 * Albumin * Calcium * LDH >600 units/l * AST/ALT >200 units Present on admission: * Age >55 years * WBC >15 x109/l * Glucose >10mmol/l * LDH >600 units/l * SGOT >250 units/l Developing during first 48 hours: * Haematocrit fall 10% * Urea increase >8mg/dl * Serum Ca * Arterial O2 saturation * Base deficit >4meq/l * Estimated fluid sequestration >600ml In Severe cases the patent is treated in ITU. There is a high chance of multiple organ failure and infected pancreatic necrosis in these patients so if there is evidence to suggest this then intravenous antibiotics should be administered straight away. The patient should be fed via a nasogastric tube and where there are gallstones present and a high probability of a severe attack early ERCP should be done. Local Complications Pancreatic necrosis is likely if the CRP is rising and is confirmed by a CT scan. Infection occurs in 30-70% of cases of necrosis and this trebles the mortality risk. Fluid collections occurs in 30-50% of patients with acute pancreatitis but in most cases resolves spontaneously. Pancreatic abscess, acute pseudocysts and pancreatic ascites can also occur (6). Systemic complications These include pulmonary oedema, pleural effusions and ARDS with regards to the respiratory system and hypovolamenia and shock with regards to the cardiovascular system. Other complications include: disseminated intravascular coagulopathy, renal dysfunction, hypocalcaemia, hypomagnesaemia, hyperglycaemia and GI haemorrhage (6). Summary Acute pancreatitis is a disease in which there is inflammation of the pancreas. Acute abdominal pain and vomiting are the most common symptoms and increased serum concentrations of the enzymes amylase and lipase can confirm the diagnosis. Injury to the pancreas is mild in 80% of patients who recover well without complications. The rest have a more severe disease and present with local and systemic complications. Alcohol abuse and gall stones are the two most common causes of acute pancreatitis in adults and treatment of mild pancreatitis is supportive and more serious disease needs intervention from quite a few members of the multidisciplinary team (5). Improving the understanding of the pathophysiology and better investigation of the disease severity should improve the management and outcome of this compound disease (5). References Bhatia M,Wong FL, Cao Y, Lau HY, Huang J, Puneet P, Chevali L. Pathophysiology of acute pancreatitis. Pancreatology [online]. 2005; 5(2-3):132-44. [cited 2009 Dec 4] Available from: URL:http://www.ncbi.nlm.nih.gov/pubmed/15849484 Ghattas K, Samer S Deeba. Pancreatitis. E medicine [online]. 2009; [cited 2009 Nov 21]. Avalable from: URL: http://emedicine.medscape.com/article/775867-overview Whitcomb DC, Yadav D, Adam S, Hawes RH, Brand RE, Anderson MA, et al.Multicenter approach to recurrent acute and chronic pancreatitis in the United States: the North American Pancreatitis Study 2 (NAPS2).Pancreatology [online]. 2008; 8(4-5):520-31. [cited 2009 Dec 1] Available from: URL:http://www.medscape.com/medline/abstract/18765957 Longmore M, Wilkinson I, Turmezei T, Cheung CK. Oxford Handbook of Clinical Medicine (Oxford Handbooks Series) 6th edition. Oxford university press; 2008 Frossard JL, Steer ML, Pastor CM. Acute pancreatitis. The Lancet [online]. 2008; 12;371(9607):143-52. [ cited 2009 Nov 23] available from: URL: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)60107-5/abstract Willacy H, Kavanagh S. Acute Pancreatitis. Patient Plus UK [online]. 2008. [cited2009 Nov 29] Available from: URL: http://www.patient.co.uk/doctor/Acute-Pancreatitis.htm