...nitroglycerin and aspirin). The goal is for every patient that is presenting with ACS is to be on the table in the cath lab undergoing intervention within one hour of presenting to the hospital with symptoms. In this paper we will address the acronym of M.O.N.A. As the protocol stands right now there are parameters for the administration of three out of the four treatments, these are morphine, nitroglycerin and aspirin. For example, the policy states we are not able to give nitroglycerin if the systolic blood pressure is below 90mm/mg or if the patient has taken any phosphodiesterase medications within 12 hours. However, there are no parameters for the administration of oxygen. Coronary heart disease is the leading cause of death within the US. Oxygen has long been advocated as standard treatment in the management of chest pain and myocardial ischemia, although, for over 60 years the scientific background for this has been questioned (Ripley, Riley, Shome, Awan, McCloskey, Murphy & DeBelder, 2012). Recent studies have shown possible negative reactions with the administration of pure oxygen with patients that were not presenting with hypoxia. The possibility for oxygen toxicity to those with ACS could cause more cardiac tissue injury due to vasoconstriction and decreased cardiac output (Williams, Gandy, & Grayson, 2013). The result of this could be poorer patient outcomes. The American Heart Association (AHA) has also been...
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...States (Office of Minority Health & Health Equity,). The Hispanics are a minority group that struggle every day to survive, to provide for their families, to stay healthy and to live quality lives. This paper will discuss the Hispanics current health status, how health promotion is defined by the Hispanics and what health disparities exist for the Hispanics. Lastly, this paper will discuss the three levels of health prevention and their effectiveness given the unique needs of the Hispanics. The Current Health Status of Hispanics How would one define health status? An individual health status could be defined by someone observing another and gathering information about that person and coming to a conclusion on the facts that were gathered. It is much harder to define the health status of a population. One way to define the health status of an entire population would be to consider the health of the population, their lifespan, the extensiveness of preventable diseases or deaths and the availability of health services that can be used as an indication of their health status (National Center for Health Statistics: Health). Some health problems that the Hispanics face today are heart disease, stroke, diabetes, chronic liver disease, cancer, asthma, obesity and tobacco use. Cardiac disease is the main cause of death for all ethnic groups in the United States and some risk factors include obesity, hypertension, diabetes, and smoking. In comparing the Hispanics to non-Hispanic white...
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...Organizational Leadership and Inter-professional Team Development The Patient and Family Care Organizational Self-Assessment Tool (PFCC) for current practice setting will be completed as well as the organization in its entirety. The results will be analyzed based on a one to five scoring system with one being the lowest. The areas where the organization could improve its PFCC care will be discussed. The analysis of how business practices and regulatory requirements impact patient family centered care. A strategy will be created that includes goals and an operational plan to increase PFCC of the organization by improving one of the gaps that’s identified. I will discuss financial implications that this strategy may have on the organization. I will identify potential members for the multidisciplinary team who could assist in improving the identified gap. I will discuss the purpose and scope of the team to include the member’s roles, and importance of diversity within the team. The team will focus in a meaningful way using self-assessment, and awareness of self-reflective techniques. I will use PDAC to monitor whether the strategy was effective in increasing patient and family centered care. Self-Assessment Tool The PFCC tool was used to evaluate Medical Center Health System (MCHS) see attached. Setting Description Medical Center Hospital System (MCHS) is an acute care, not for profit regional 402 bed Level II Trauma Center, located in West Texas of the...
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...right then at that very moment that I wanted to be a nurse. Here are a couple things that I found to be interesting about nursing. Did you know that Jan 27th is school nurse day? Or did you know that in 1783 a black slave named James Derham worked as a nurse in New Orleans, eventually earning enough money to buy his freedom and move to Philadelphia, where he studied medicine and became a doctor? And I also bet that you didn’t know that the largest demand for Licensed Practical Nurses through 2110 will be in nursing homes? Or that the 4th week of May is National Nurses week, which is coming up pretty soon. And May 8th is national Student Nurses’ day (Start a nurse staffing agency). Well I didn’t know any of that either until I started my paper on my nursing career. In December 2010 I finished my schooling for a Licensed Practical Nurse at the JCTC Campus in the accelerated program. I chose to start out at that campus because its only five minutes from my house, and it was only for about ten and a half months. Now that the LPN program is over and I have completed my one hundred and twenty internship hours and passed the NCLEX exam, I am taking a couple more classes along with the ADN program courses. ADN is an Associate’s degree in nursing which is known more commonly as an RN (Registered...
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...Epidemiology Paper Monica Okoro Nur/408 Epidemiology: Global and Public Health September 10, 2012 Diane Campbell, DNP - PHN, FNP - BC Epidemiology Paper Public health nursing allows nurses to encounter various vulnerable populations on a daily basis. In particular, the elderly make up a large portion of the population, and their vulnerability to the environment and other physical factors is a very important aspect of public health nursing. Epidemiology allows the public health nurse to study and assess vulnerable populations, including the elderly, and create interventions that maximize the health potential of all members of the public. This paper will explore the role of epidemiology and also discuss the definition and purpose of epidemiology, epidemiological methods, the epidemiological triangle and levels of prevention that is related with influenza in the elderly community. Definition and Description of Epidemiology Originally, epidemiology was a term that was used to describe the spread of infectious disease. Over the course of time, that definition has expanded considerably in order to accommodate the complexity of ever-changing populations, their environments, and increasing occurrences of disease. Epidemiology is a branch of public health that studies of the frequency, distribution, and determinants of disease in human populations. It studies the patterns of diseases in human populations and how to control health problems associated with disease...
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...STATE UNIVERSITY OF NEW YORK AT ALBANY Emanuel Medical Center Situational & Decision Analysis James T. Onisk 4/29/2012 Table of Contents Situational Analysis Appendices External Analysis Appendix A: S.W.O.T. Analysis Appendix B: External Trend/Issue Analysis Appendix C: Environmental Trends/Issues Plot Appendix D: Stakeholder Map Appendix E: Service Area Profile Appendix F: Service Area Structural Analysis Appendix G: Service Area Competitor Analysis Appendix H: Critical Success Factor Analysis Appendix I: Mapping Competitors Appendix J: Synthesizing the Analysis Internal Analysis Appendix K: Financial Analysis Appendix L: Value Chain Strengths and Weaknesses Appendix M: Value Chain Competitive Advantages Relative to Strengths Appendix N: Value Chain Competitive Disadvantages Relative to Weaknesses Appendix O: Strategic Implications of Strengths and Weaknesses References Decision Analysis Decision Analysis Appendices Appendix P: Directional Strategies Appendix Q: Adaptive Strategies Appendix R: Market Entry Strategies Appendix S: Strategic Positioning Appendix T: Value-Chain Funcations References 1 2-11 12-13 14-17 18-29 30-36 37-50 51-60 61-66 67 I-VII 68-74 75-81 82-86 87-91 92-95 96-105 VIII-XV 106-109 110-122 123-125 126-128 129-135 136 Issue Statement Emanuel Medical Center (EMC) is encountering tremendous financial troubles as it struggles to remain open as an independent general acute care hospital. Changes in federal regulations such as the implementation...
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...Term Paper Report On Competitive Marketing Policies & Strategies Of Pharmaceutical Products in Bangladesh Submitted to Mr. Abdus Samad Chowdhury Senior Management Councilor Bangladesh Institute of Management Submitted By MD. MAHAFUZUR RAHMAN ID: 14MM028 Post Graduate Diploma In Marketing Management Date of Submission 21-12- 2014. Bangladesh Institute of Management Department of Marketing Management Letter of Transmittal December 21, 2014 Mr. Abdus Samad Chowdhury Bangladesh Institute of Management Subject: Request to accept my term paper report on competitive marketing policies & strategies of Pharmaceutical Products in Bangladesh. Dear Sir, I have given a topic on “Competitive Marketing Policies & Strategies of Pharmaceutical Products in Bangladesh” for writing a term paper for presentation, collection of primary data and secondary data. To do so, we sought the relevant information from books, newspaper and websites. We also went to many respondents who are closely related this entire process. I tried to collect all possible information and make this paper acceptable to all but there can be still existing mistake. So we like to request you to consider if any fault is found in this paper. Finally I would like to request you to accept our paper and permit us to present it before the panel of experts. Yours Sincerely Md. Mahafuzur Rahman Roll No : 14MM028 Post Graduate Diploma in Marketing Management. Bangladesh...
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...Overview of Cocaine Jasmine Wright Research Paper Professor Suh It is a Friday night and your roommates at your dorm invite you to a dorm party. Instead of finishing your homework you decide to join them and put the homework off for tomorrow. You tell yourself that you wont be out so late and that you had a long week so why not. As you arrive to the party, there are girls kissing up on boys as they take shots. You tell yourself that you would not participate because your parents did not grow you up in that kind of manner. As the night passes, your roommates pressure you into taken a shot of tequila. Eventually, one shot turns into two and then three. Until, the shots are not enough. Your roommate turns to and says, “Try this”. She passes you a little “baggy” of a white powder substance. You ask, “What is it?” She replies, “ it’s coke, you’ll love it.” You take the rolled up bill from her hand and you try your first line of coke. At that moment, you fell in love and life was no longer the same. Cocaine became prevalent in 5,000 B.C. of the Inca Empire in Peru. It is derived from cocoa plants were they would chew the leaves and extract the cocoa from it. It effect can be increased by adding calcified lime to raise the alkalinity which improves the effect of cocaine. This would be of assistance to them when they had to travel great distances due it increasing their endurance and strength. Eventually, the demand for cocaine grew high in the field of medicine. A surgeon, Halsted...
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...Epidemiology by definition is the study of the distribution and patterns of health-events, health- characteristics and their causes or influences in well-defined populations. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based by identifying risk factors for disease and targets for preventive medicine. Epidemiologists are involved in the design of studies, collection and statistical analysis of data, and interpretation and dissemination of results (including peer review and occasional systematic review).Major areas of epidemiological study include outbreak investigation, disease surveillance and biomonitoring, and comparisons of treatment effects such as in clinical trials. Epidemiologists rely on a number of other scientific disciplines such as biology (to better understand disease processes), biostatistics (to make efficient use of the data and draw appropriate conclusions), and exposure assessment and social science disciplines (to better understand proximate and distal risk factors, and their measurement). I would like to discuss elderly patients as my vulnerable population. There is no set age at which a person maybe under the care of a geriatric physician. The physician aims to promote health by preventing disease and disabilities in geriatric adults. A gerontologist specializes in the aging process. Adult medicine differs from the geriatric patient because the focus is on the elderly...
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... Page 8 Conclusion Page 9 References Page 10 Appendix I Page 11 Appendix II Page 11 Appendix III Page 12 Appendix IV Page 13 Appendix V Page 13 Appendix VI Page 16 Abstract This paper will focus on the clinical manifestations of hepatic encephalopathy and its effects on Mrs. X. She is a 64 year old female who has been an alcoholic for more than 40 years. The constant abuse of alcohol has left her with cirrhosis of the liver. One problem of cirrhosis is the inability of the liver to filter ammonia. When the levels of ammonia build up in the body, it affects various organs and systems. In Mrs. X’s case, it affected her brain. She manifested impaired cognitive abilities as well as physical limitations. This case study will expand on these processes as well as her prognosis and nursing implications. Hepatic Encephalopathy Mrs. X is a 64 year old white female and was a functional alcoholic and smoker for more than 40 years. She presented to the E.R. from home with complaints of lethargy, confusion, and decreased mobility. This paper will discuss the clinical manifestations of hepatic encephalopathy and the effects it has had and still do on Mrs. X’s mind, body, and soul. Mosby’s medical dictionary (2007) defines hepatic encephalopathy as: A neuropsychiatric manifestation of extensive liver...
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...FSU Winner Florida State’s Caitlin Quinn has been named the NSCA’s Assistant Strength Coach of the Year. http://www.seminoles.com/sports/w-softbl/spec-rel/112613aaa.html Critical Condition A California high school football player is in critical condition after suffering neck and spinal cord injuries during a game. http://www.pe.com/local-news/riverside-county/corona/corona-headlines-index/20131124-santiago-football-player-remains-in-critical-condition.ece State Total More than 4,400 middle and high school student-athletes in Massachusetts suffered head injuries last year, according to reports filed by the schools. http://www.bostonglobe.com/metro/2013/11/25/mass-schools-report-head-injuries-among-athletes-compliance-with-concussion-law-rises/njPFK6a92knIhcvY9UGxdN/story.html Refueling Product A new product can allegedly help athletes refuel during competition by providing precise carb and electrolyte recommendations based on a quick analysis of their sweat. http://www.prweb.com/releases/FuelstripMMA/UFCBellator/prweb11284260.htm Vegan Praise Several top athletes credit veganism with playing a key role in their success. http://www.news.com.au/lifestyle/health/elite-athletes-reveal-the-vegan-diet-secret-behind-their-success/story-fneuzkvr-1226768537898 Baseline Challenges Three new studies of baseline testing highlight the difficult of accurately assessing an athlete’s true baseline ability. http://www.momsteam.com/studies-show-pitfalls-in-baseline-neurocognitive-testing ...
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...THE NERVOUS SYSTEM The nervous system allows the animal to quickly detect, communicate and co-ordinate information about its external and internal environment so it can make efficient appropriate responses for survival and/or reproduction. The two major parts of our nervous system are the central nervous system (CNS) and peripheral nervous system (PNS). The CNS is made of the brain and spinal cord. The cranial nerves, spinal nerves and ganglia make up the PNS. The cranial nerves connect to the brain. The cranial and spinal nerves contain the axons (fibres) of sensory and motor nerve cells. Nerve cells areas are also known as neurons. Neurons are the basic unit of the nervous system. They carry information or impulses as electrical signals from one place to another in the body. There are 3 types of neurons: Sensory Neurons- Sensory neurons carry electrical signals (impulses) from receptors or sense organs to the CNS. Sensory neurons are also called afferent neurons. The cell body of sensory neurons is outside the CNS in ganglia. Motor Neurons- Motor Neurons Carry Impulses From The CNS To Effector Organs Motor Neurons Are Also Called Efferent Neurons. The Cell Bodies Of Motor Neurons Are Inside The CNS. Interneurons- These are also called intermediate, relay, or associative neurons. They carry information between sensory and motor neurons. They are found in the CNS. TOP The Structure of Neurons A Neuron consists of THREE MAIN PARTS: A. CELL...
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...APPENDIX Checklists A Checklist A-1 Reviewing a Budget 1. Is this budget static (not adjusted for volume) or flexible (adjusted for volume during the year)? 2. Are the figures designated as fixed or variable? 3. Is the budget for a defined unit of authority? 4. Are the line items within the budget all expenses (and revenues, if applicable) that are controllable by the manager? 5. Is the format of the budget comparable with that of previous periods so that several reports over time can be compared if so desired? 6. Are actual and budget for the same period? 7. Are the figures annualized? 8. Test one line-item calculation. Is the math for the dollar difference computed correctly? Is the percentage properly computed based on a percentage of the budget figure? 333 334 APPENDIX A Checklists Checklist A-2 Building a Budget 1. What is the proposed volume for the new budget period? 2. What is the appropriate inflow (revenues) and outflow (cost of services delivered) relationship? 3. What will the appropriate dollar cost be? (Note: this question requires a series of assumptions about the nature of the operation for the new budget period.) 3a. Forecast service-related workload. 3b. Forecast non–service-related workload. 3c. Forecast special project workload if applicable. 3d. Coordinate assumptions for proportionate share of interdepartmental projects. 4. Will additional resources be available? 5. Will this budget accomplish the appropriate managerial objectives for...
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...Essentials Ruth E. McCall, BS, MT (ASCP) Retired Program Director and Instructor Central New Mexico Community College Albuquerque, New Mexico President, NuHealth Educators, LLC Faculty, Emeritus Phoenix College Phoenix, Arizona Fifth Edition Cathee M. Tankersley, BS, MT (ASCP) Acquisitions Editor: Peter Sabatini Product Manager: Meredith L. Brittain Marketing Manager: Shauna Kelley Designer: Holly McLaughlin Production Services: Aptara, Inc. Fifth Edition Copyright © 2012, 2008 by Lippincott Williams & Wilkins, a Wolters Kluwer business. Two Commerce Square 2001 Market Street Philadelphia, PA 19103 351 West Camden Street Baltimore, MD 21201 Printed in China All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at permissions@lww.com, or via website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Library of Congress...
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...TENNIS RECOVERY A Comprehensive Review of the Research Editors: Mark S. Kovacs, PhD Todd S. Ellenbecker, DPT W. Ben Kibler, MD A United States Tennis Association Sport Science Committee Project Tennis Recovery: A Comprehensive Review of the Research Copyright © 2010 United States Tennis Association Inc. ISBN 978-0-692-00528-6 Editors: Mark S. Kovacs, Todd S. Ellenbecker, W. Ben Kibler TENNIS RECOVERY A Comprehensive Review of the Research A United States Tennis Association Sport Science Committee Project Editors: Mark S. Kovacs, PhD Todd S. Ellenbecker, DPT W. Ben Kibler, MD Introduction In the last two decades, physical training and competitive opportunities have increased dramatically in junior, collegiate and professional tennis. This arose due to a multitude of factors, but much of it has stemmed from an increase in knowledge and understanding of scientifically based training programs focused on improving performance. As this focus on performance has increased, the area of recovery has received relatively limited focus. Recovery is a multi-faceted paradigm focusing on recovery from training—session to session, day to day and week to week. Recovery is also vitally important during training as well as in competition between matches and between days during multi-day tournaments. As more information is needed in the area of tennis specific recovery, the Sport Science Committee of the United States Tennis Association (USTA) sponsored an extensive evidence-based...
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