Research Articles Base: Medical Education

Chronic Kidney Disease as a Risk Factor for Cardiovascular Disease and All-Cause Mortality

Study design: This particular research activity was conducted using the secondary evaluation of four community-based, longitudinal public-use data sets in order to determine the relationship of baseline kidney function and long-term risk of cardiovascular disease (CVD) and all-cause mortality. As such, the researchers included the AtherosclerosisRisk in Communities Study (ARIC), the Cardiovascular Health Study (CHS), the Framingham Heart Study (FHS), and the Framingham Offspring Study (Offspring) as data pool that were analysed accordingly as studies that have meticulous ascertainment of CVD events during theirfollow-up periods.     Background/Objectives: The completion of the research activity was grounded on the attainment of the following research objectives that likewise state the purpose of the study:   <li class="MsoNormal" style="text-align: justify; line-height: 200%"> To pool the findings fromseveral large community-based cohort studies. </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> To evaluate moresystematically whether chronic kidney disease (CKD), as quantified by estimated GFR,is a risk factor for CVD.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> To investigate the effect of moderate and severeCKD outcomes in subjects without CVD at baseline. </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> To identify high-risk subgroups particularly the differences between blackand white subjects as a trend toward a differing impact of CKD. </li>     Population number and social demographic parameters: Since the study was completed based on previously conducted research activities, the sampling population was directly sampled from the techniques used by the cohorts. The population included the following:   <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Between 1987 and 1989, ARIC enrolled 15,792 participants aged45 to 64 yr from Jackson, Mississippi; Forsyth County, NorthCarolina; the northwestern suburbs of Minneapolis, Minnesota;and Washington County, Maryland. (The Mississippi cohort is entirelyblack and composes >80% of the black individuals in ARIC.)</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> CHS is a population-based study of 5201 subjects 65 yr and olderrandomly selected from Medicare eligibility files during 1989and 1990 from four different communities: Sacramento County,California; Washington County, Maryland; Forsyth County, NorthCarolina; and Pittsburgh, Pennsylvania. (An additional 687 blackswere recruited in 1992 and 1993. )</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> FHS began in 1948 with 5209 residents of Framingham, Massachusetts, aged 28 to 62 yr. Serum creatinine levels were initially assessed at the 15th biennial examination (1977–1979; n = 2632) in FHS. </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Offspring recruited5124 of the children and the spouses of children of FHS participantsin 1971, and serum creatinine was assessed at the second examination (1979–1983; n = 3863). </li>   The 15th examinationin FHS and the second examination in Offspring were consideredto be the baseline period for our current analysis.   Sampling frame and sampling strategy: The researchers excluded 575 subjects who had data missing on age, race,gender, or creatinine or were of nonwhite/nonblack race; 36subjects with glomerular filtration rate (GFR) <15 ml/min per 1.73 m2; 93 subjects whodid not provide permission to release data; three subjects withoutfollow-up data; 556 subjects with missing baseline CVD data;and 4278 subjects with preexisting CVD. The final study population consisted of 22,634 subjects. Since a totalof 602 subjects had missing single data points, such as systolicBP and total cholesterol, single imputationwas performed on the basis of age, gender, and race stratifiedmeans. Although analyses were performed using both the imputed and non-imputeddata, the final models were based on the imputed results.     Inclusion criteria and exclusion criteria: Baseline characteristics included the following criteria:     <li class="MsoNormal" style="text-align: justify; line-height: 200%"> demographics <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> age</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> gender</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> race</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> education level </li> </ul> </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> lifestyle <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> smoking </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> ]alcohol intake</li> </ul> </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> medical history <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> baseline CVD </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> diabetes</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> hypertension</li> </ul> </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> medication use <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> antihypertensive agents </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> lipid-lowering agents</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> diabetes medications</li> </ul> </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> physical examination findings <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> height</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> weight </li> <li class="MsoNormal" style="line-height: 200%"> body mass index (BMI) </li> <li class="MsoNormal" style="line-height: 200%"> systolic and diastolic BP </li> <li class="MsoNormal" style="line-height: 200%"> left ventricular hypertrophy (LVH) by electrocardiogram</li> </ul> </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> laboratory variables <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> total cholesterol </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> HDL cholesterol </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> creatinine</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> glucose</li> </ul> </li>     Screening tests, clinical parameters and laboratory parameters: In order to meet the criteria set by the researchers to the selected population representatives and participants of the study, the following screening tests, clinical parameters and laboratory parameters were utilized:   <li class="MsoNormal" style="text-align: justify; line-height: 200%"> BMI was calculated using the formula weight (kg)/height2 (m).</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Total cholesterol and HDL cholesterol were measured in all studies.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Urinalysis results were not available for all studies; therefore,proteinuria was not included as a variable. </li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> LVH was derivedfrom electrocardiographic criteria.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Baseline CVD included a history of both recognized and silentmyocardial infarction (MI), angina, stroke, transient ischemicattack, and intermittent claudication as defined by consensuscommittees for the respective studies. </li>   BaselineCVD included a history of congestive heart failure in CHS, FHS,and Offspring (not coded in ARIC) and a history of angioplastyand coronary bypass procedures in ARIC and CHS (not availablein the Framingham cohorts).     Results: Upon careful analyses and evaluation of the data that were utilized in the research activity, the following information was presented as results and findings of the study:   ·        The mean serum creatinine for both whites and blacks was 0.9mg/dl. The mean estimated GFR was 88.6 ml/min per 1.73 m2 forwhites and 99.9 ml/min per 1.73 m2 for blacks. ·        CKD was presentin 1664 subjects. The CKD group was composed of 1505 (8.1%)white and 159 (3.8%) black subjects; 19% of patients with CKDwere from ARIC, 47% were from CHS, 25% were from FHS, and 9%were from Offspring. ·        In patients with CKD, the mean estimatedGFR was 51.9 ml/min per 1.73 m2 for whites and 49.6 ml/min per1.73 m2 for blacks. But because of the large study sample, all studyvariables were significantly different between the white andblack subgroups. ·        The prevalence of traditional CVD risk factors was higher inpatients with CKD as compared with those without CKD. ·        Patientswith CKD were older and more likely to include those with ahistory of hypertension and diabetes.     Conclusion and discussion: The study suggested that the presence of CKD isan independent risk factor for adverse outcomes in a large, pooled, community-based cohort of patients without CVD. Therisk associated with CKD appears to be stronger in blacks thanin whites. Moreover, evidence that patientswith CKD should be considered at high risk for CVD and mortalityoutcomes. Lastly, patients with CKD are potential candidatesfor aggressive risk factor reduction.     Limitations: Because the public-use databasedoes not provide center information in ARIC and CHS due confidentiality concerns, the researchers were not able to adjust for differencesor clustering of outcomes as a result of center effects. As such theyseveral socioeconomic variables (education, race, smoking, andalcohol use) were used to control for such centrality effects.   Moreover, the definition of CKD in the study was singularly based on serum creatinine assessment which could have likely introduced misclassificationbias. It should also be taken into consideration that these studies evaluated subjects when they were at their baseline and presumably free of acute illnesses that mayaffect serum creatinine.   Despite the large study population, there were relativelyfew blacks with CKD which were selected as samples. However, the relationship betweenblacks with CKD and adverse outcomes was highly significant.   Furthermore, the study likewise lack data on several more recently identified risk factorsfor CVD that may be especially prominent in patients with kidneydisease such as C-reactive protein, homocysteine,and albuminuri.   Finally, the researchers were not able to adjust forchanges in medication use during follow-up or to assess theimpact that several newer therapies like statins and renin-angiotensin-aldosteronesystem blockade, which may have had on CVD outcomes indicated in the cohorts. Credit:ivythesis.typepad.com

Chronic Kidney Disease as a Risk Factor for Cardiovascular Disease and All-Cause Mortality

Study design: This particular research activity was conducted using the secondary evaluation of four community-based, longi...

Medical and Surgical Nursing

Introduction Medical and surgical nursing has long been considered the foundation of nursing. Care of the adult is the keystone of medical-surgical nursing. This care can be in the acute care setting, in the home, in outpatient settings, or in the community. The care provided is holistic and is rooted in health promotion, disease prevention, health restoration, and health maintenance (Grindel, 2005). Medical-surgical nursing focuses on nursing care of the adult client and is recognized as the bedrock of nursing practice. Nursing care in this specialty is not centered on a setting or a body system, but encompasses the domain of nursing care of adults. Medical-surgical nursing care is provided to adults around the world. In many situations, medical-surgical nurses are the only specialty nurses available to provide care for adults (Grindel, 2005).  This paper focuses on the problems surgical medical nurses face, and the probable solution that one may come up with: surgical masks and sanitation.  Research on the increasing incidence of complications or infection after surgical tracheostomy and other surgical procedures are performed in critically ill patients in nursing care settings will be critiqued as well as how this problem can be solved by providing solutions designed for the apparent cause of the problem. The tools to be used to explore the issue will include researching many reading materials regarding the topic and put it together in a meaningful whole. A personal analysis on the problem will also be presented and as well as recommendations on how the quality of care can be improved regarding the particular problem in surgical medical nursing.   Research and Findings In a nationwide study focusing on the state of research utilization in the United States, it revealed that the culture of healthcare institutions does not value research utilization. The study noted that nurses without a baccalaureate degree did not fully understand or value research, while some of the baccalaureate-prepared nurses who had classes on research in their program complained that the way in which nursing research was taught in the schools turned them off (Olade, 2003). These are just some examples that depict the increasing lack of awareness and utilization of many health care professionals. The purpose if this paper is to identify the main reasons why nurses do not utilize research in their practice; discuss three of these reasons and why they exist; and make evidenced based recommendations for future nursing practice to overcome each of these three barriers.             There are two major approaches to investigating diverse phenomena in the field of nursing research. These approaches originate from different philosophical perspectives and use different methods for collection and analysis of data. Nurses who care for patients with brain injuries face unique challenges, especially when it comes to caring for the patient during recovery. Patient care can be time consuming and complex, with appropriate treatment and rehabilitation varying from patient to patient. Interactions with patients’ families place further demands on nurses’ time and energy. Ineffective communication between anxious family members and healthcare providers has been identified as a major source of stress for both nurses and families (Davis, Kristjanson, & Blight, 2003), as well as a factor in the success or failure of a patient’s recovery.             Contemporary changes in the healthcare setting have created further challenges not only for the nurses but also for the patient recovering from the brain injury. Nursing shortages have led to increased patient care loads, and managed care has led to shorter hospitalizations. The result is that less time is available for healthcare providers to anticipate and meet the needs of those family members assuming caregiver responsibilities. Nurses require specialized training and resources to help families cope with the effects of brain injury upon recovery.             Neuroscience nurses practicing in the community or within rehabilitation programs are well-positioned to assess and comprehensively refer and manage the brain injury survivor upon recovery. It is important to note that there are some negative effects on the patient after the brain injury. Physical changes may include sensory deficits (e.g., visual or heating impairment), diminished coordination and muscle control, fatigue, seizure disorders, and headaches. The physical changes are generally the most easily recognized by others. In addition, typical emotional changes include emotional liability, decreased inhibition, increased anger, depression, frustration, and anxiety. These post- brain injury alterations become most apparent to family members or co-workers. Cognitive changes post- brain injury may create additional rehabilitation needs and include decreased short-term memory, inability to maintain attention/concentration, difficulty with receptive and/or expressive communication, and poor organization/planning. These changes once again are most noticeable to those who have close contact with persons who have brain injury (Kay & Lezak, 1990). Pharmacotherapies may be indicated, yet there is no substantive evidence on the most effective drugs. Because primary depression is best treated when pharmacotherapies are combined with strengthening interpersonal relationships, similar strategies should be employed with this population (Jean-Bay, 2000). Kay & Lezak (1990) described cognitive changes with greater specificity by discussing the pervasive limitations that impaired executive functioning may present. Diminished executive functioning is connected to frontal lobe damage, and simply put, is “an organically based inability to plan, put into action, and carry through with an appropriate course of action.” It is well established that irreversible tissue damage following brain trauma is a result of primary and secondary processes. The primary injury occurs at the time of the traumatic event and encompasses mechanical processes such as neuronal shearing, transection and axonal injury. Obviously, these primary events cannot be prevented once the trauma has occurred. However, secondary injury develops over time following the primary traumatic insult. Recent evidence suggests that much of the irreversible damage after brain injury is actually caused by these secondary events initiated at the time of trauma but taking hours to days after the insult to resolve. The time factor involved in the secondary injury process suggests that irreversible brain injury may be prevented or at least attenuated. As such, understanding the role of these secondary mechanisms in the injury process permits the implementation of nursing care practices that may potentially minimize irreversible tissue damage (Vink, 1999).               Training and inclusion of the family in patient care is a concept that most nurses felt would lessen negative encounters. Approaching care from the perspective of the nurse-family team helped instill a sense of control in family members. It should be pointed out, however, that “not all families want to be involved in care. Some are scared, and some think that the nurses are not doing their job if they ask the family to help. Although family involvement in care is needed, the critical care environment can be intimidating during the early phases of care, so family members must be approached cautiously and individual circumstances carefully assessed when involving them in physical care of the patient.               Quantitative research progresses through systematic, logical steps according to a specific plan to collect numerical information, often under conditions of considerable control, that is analyzed using statistical procedures. The quantitative approach is most frequently associated with positivism or logical positivism, a philosophical doctrine that emphasizes the rational and scientific. Quantitative research is often viewed as “hard” science and uses deductive reasoning and the measurable attributes of human experience (Kozier & Erb, 2004).             The qualitative approach is often associated with naturalistic inquiry, which explores the subjective and complex experiences of human beings. Qualitative research investigates the human experience as it is lived through careful collection and analysis of narrative, subjective materials. Data collection and its analysis occur concurrently. Using the inductive method, data are analyzed by identifying themes and patterns to develop a theory or by identifying themes and patterns to develop a theory or framework that helps explain the processes under observation (Kozier & Erb, 2004). Tracheostomy refers to an opening into the trachea where an artificial airway (the tracheostomy tube) is inserted. This is usually performed to protect the patient from accidentally inhaling food, fluid or saliva. Such an airway may be necessary for patients when prolonged ventilation is required, or when an extended coma is anticipated. It may also be placed surgically to maintain the structure of the trachea–when threatened by cancer, infection or trauma, Placement of a tracheostomy is mainly used during the acute phase of an illness and later removed (Wright, 2005). A client may have a tracheostomy to bypass an upper airway obstruction, prevent aspiration, manage tracheobronchial secretions, or allow for prolonged mechanical ventilation. Whatever the reason for tracheostomy, the client should be provided standardized care in tracheostomy management. Lately, the rising incidence of chest infections in patients undergoing tracheostomy in my place of employment had been largely blamed on the part of the nurses. Such poor quality of practice is a no-no in the healthcare field. If nurses are not aware of the recommended and safe procedure, then the lives of clients are in jeopardy. Nurses are instrumental in helping tracheostomy patients cope through symptom management, emotional support, and patient education. By increasing their awareness of this disorder and the challenging nature of its diagnosis, nurses can help identify patients needing care. Risk management is important. It is about identifying, measuring and controlling those risks that threaten quality or performance in the delivery of patient care (Metcalfe, 2002). Every day, nurses help patients through education, empowerment and expertise to avoid the recognized complications associated with tracheostomy care. They give practical advice and support to people with who underwent tracheostomy to manage risky situations such as an episode of chest infections, encouraging the patient and the family to learn from the event and employ tactics to prevent recurrence. This is a proactive risk management strategy that involves the recognition and identification of things that can go wrong as part of a systematic approach to patient care. Patients are empowered to respond appropriately in a risky situation. While the existing literature points to the deep impact that surgical tracheostomy can have on patient’s lives, there is nonetheless a scarcity of research on the particular issues of infection after tracheostomy. Although surgical tracheostomy has become a procedure that is commonly performed in critically ill patients, the morbidity of the different surgical techniques currently used in ICUs is not well-known. For this reason the medical and mental health communities are unaware of the best way to assist surgical tracheostomy patients with infection in their recovery. To address this gap in the literature, this particular study was conducted which specifically explored the incidence and severity of complications and infections associated with subthyroid tracheostomy and cricothyroidotomy when performed in the ICU. For this proposal, the author employed a combination of qualitative methods. This study examined individual consecutive patients who were undergoing elective tracheostomy rather than experimental manipulation of these variables. Attending physicians elected the timing and technique of the tracheostomy. All procedures were performed at the bedside. A complete laryngeal examination was performed before ICU discharge, prior to decannulation, and 6 months after the tracheostomy. Over a 2-year period, all patients hospitalized in the 22-bed ICU of Limoges University Hospital (France) who underwent an elective tracheostomy were studied. Exclusion criteria included the following: (1) having undergone an emergency tracheostomy and (2) a history of previous tracheostomy, neck surgery, cervical irradiation, or laryngeal disease. In each patient, the following parameters were noted: age; sex; body mass index; APACHE (acute physiology and chronic health evaluation) II score on ICU admission; reason for admission to the ICU; length of ICU stay; indication for tracheostomy; duration of mechanical ventilation prior to tracheostomy; number of endotracheal intubations prior to tracheostomy; duration of cannulation; as well as different factors that could result in a technically challenging surgical tracheostomy, including the presence of a distorted neck anatomy or coagulopathy. The ICU morbidity and mortality at 6 months after ICU discharge also were recorded.      Patients were divided into two groups, according to the technique of tracheostomy used (subthyroid tracheostomy vs surgical cricothyroidotomy). Randomization was not performed since the technique of surgical tracheostomy was chosen by each attending physician based on anatomic or functional factors that are known to influence the feasibility of the procedure. Cricothyroidotomy was performed in the presence of at least one of the following criteria: (1) severe distortion of neck anatomy; (2) morbid obesity; or (3) patients with poor prognoses. In the absence of these criteria, a conventional subthyroid tracheostomy was usually performed. The main limitation of this study is that the tracheostomy technique was chosen by the referring physicians based on anatomic and functional factors, rather than by randomization. This may have introduced a substantial bias since surgical cricothyroidotomy was more frequently performed in the presence of criteria that traditionally have been associated with the performance of technically difficult conventional subthyroid tracheostomies. However, with the exception of age and body mass index, both study groups were comparable for all other characteristics. In addition, the power analysis showed that the size of our study population was adequate to detect a difference of 20% in the incidence of major complications between groups. Several cases of deaths have been note over the years. Deaths have been usually attributed to incidents like road accidents, fights, fires, natural catastrophes and other such happenings. But recently, a number of deaths have been attributed to medical “errors”- often referring to death by infection, or other medical complications (Black and Weinstein, 2000). Wearing a face mask greatly reduces the risk of acquiring deadly infections. But according to Derrick and Gomersall (2005), face masks do not filter much of the minuscule particles that needed to be kept out of the system. Face masks are designed to keep other people from transmitting infectious diseases and viruses to others, but  they themselves are not protected by the face masks they wear ( Derrick and Gomersall, 2005). Credit:ivythesis.typepad.com

Medical and Surgical Nursing

Introduction Medical and surgical nursing has long been considered the foundation of nursing. Care of the adult is the keystone of me...

Medical and Surgical Nursing

Medical and Surgical Nursing

Introduction Medical and surgical nursing has long been considered the foundation of nursing. Care of the adult is the keystone of me...

WHY DO YOU WANT TO GO TO PHARMACY SCHOOL?

Having the basic background about pharmacy, I am well aware of the demands this course would require. In spite of this, I am very determined to become a pharmacist. This confidence is actually derived from three essential keys that I have, which I believe will help me accomplish all the requirements in the pharmacy course. These keys include my experience, interest and character. For the past two years, I have been working in a pharmacy, which allowed me to be exposed on the different responsibilities of a pharmacist. This experience also taught me the different skills and important information that a pharmacist must know in actual practice. The working experience I had in the pharmacy also helped me obtained one of my important keys, and that is interest. As I was able to observe a professional pharmacist during my work experience, I became more interested to become like one in the future. I extremely believe in the concept that doing things, no matter how difficult they are, becomes easy as long as you are interested in doing them; thus, I consider my interest on pharmacy as a key for me to overcome the challenges of pharmacy education. Even at a young age, my interest for pharmacy was exhibited through my interest in science and math. Furthermore, when my grandmother was ill, I developed a deep curiosity on medicines and their ability to heal all sorts of diseases. Here, I was able to familiarize myself about the different drugs and their distinct capabilities to cure. From curiosity, I became more determined to work in the healthcare field and contribute to the health maintenance of several people. As a working student, I was able to develop a sense of responsibility towards my work and school duties. I learned how to balance my time; despite the difficulty of the tasks I have to do, my working student days taught me how to motivate myself and persevere to achieve my objectives. With this character, I believe I have the right attitude to pursue pharmacy education; this would greatly help me overcome all challenges the course has in store for me. With all these keys combined, I strongly believe that I have the basic requirement to be accepted in a pharmacy school and begin my journey as a future pharmacist.           Credit:ivythesis.typepad.com

WHY DO YOU WANT TO GO TO PHARMACY SCHOOL?

Having the basic background about pharmacy, I am well aware of the demands this course would require. In spite of this, I am ...

Diversity

There is much to be concerned with especially when presented with such a case. As a nurse, my first concern will, of course, be the medical one especially since my training has helped strengthen my belief that only when one is healthy and sound both in body and mind will there be advancements in other aspects.             However, in the case of the Rodriguez family, who have been my friends for some time now, several problems have come at once and, based on their background, their physical health is not the only problem that they are currently facing. From my analysis, one of the biggest problems is the sociological background of our town as well as the limited knowledge of the citizens concerning their rights. It is assumed that the Rodriguez family is not the only family that is facing these problems, but also many of the families and people in our town. Thus, the first step that must be taken should be to educate everyone concerning their rights and benefits and how they will be able to achieve these.             First of all, one of the problems that should be addressed is the hiring and promotion of people despite having lack of education. Based on an article by Brand (2003), lack of education can be one of the factors for the continuation of lack of promotions. Although the article did not give specific ways on how this problem will be addressed, one of the things that the workers, including Jamaal, can do is to ask their supervisor if their lack of education is the reason for their being held back. If it is, they should request that fair judgment based on their labor be their background. Through this, the workers may possibly be able to gain equal status with their other co-workers despite their education problem.             Because of the continued problems with their work, one of the community projects that may be done is a seminar for people in the town concerning their rights that are placed under the Department of Labor. The Department of Labor, especially those who are in the Office of Disability Employment Policy and those who belong to the Fair Pay Department be able to give the people in the community some tips and some updates concerning the laws in which they fall under. Joyce may be able to find other work that will enable her to work at home and something that is not stressful for her. She may be able to obtain help from the Department of Labor or even through asking around from her friends. With this, any concerning labor problems and hindrances may be addressed in the seminars, as well as their knowledge concerning their rights will be increased.             When it comes to the school, there may be some other way for the school to continue. Fundraisers may be organized in order to help the school gain some money. At the same time, the community may recruit the help of the Department of Labor, especially the section concerning Elementary and Secondary Education. Once it is made clear that the community cannot afford to lose the school and that having it will be beneficial to the community children more than if it is closed, then there is the possibility that the school will be granted some time before it will be closed, in time for the community to gather together and organize fundraisers and recruit the help of other divisions of the Department of Education.   Credit:ivythesis.typepad.com

Diversity

There is much to be concerned with especially when presented with such a case. As a nurse, my first concern will, of course, be the medica...

Study Habits of the Respiratory Students in thier Major Subjects

STUDY HABITS OF THE RESPIRATORY STUDENTS IN THEIR MAJOR SUBJECTS         Respiratory diseases are medical terms for various type of respiratory problem being encountered by people who suffered from pathological conditions that affects the bronchi and the muscular nerves for breathing. There are various types of respiratory diseases such as common colds, asthma, respiratory tract infection, lung cancer and pneumonia and many others. The diseases they may encounter can be mild to severe that if not cured can lead to a more serious conditions.         Students who are studying this kind of respiratory therapy are required to master each major subject that are at most important to their patients before they are assigned to their respective hospitals as intern. They must be consistent about their focused subject in order to perform major evaluation and testing on their patients. Their major subjects include cardiopulmonary diagnostic, respiratory pharmacology, cardiopulmonary physiology. They must also be proficient in science and mathematics since their course requires many computation and scientific analysis according to their patient’s performance and wellness.       Students study habits includes patience and commitment for evaluation and testing their patients, they must learn to devote their time in studying their major subjects to necessarily complete the academic standard that is required to be competent in becoming a respiratory therapist. They must also possess the clinical competence since they will be doing clinical works and other clinical program that concern their expertise. They must be knowledgeable in laboratory competence more than just in school but also through actual training. During laboratory simulation they must show a natural discipline and performance and they must be realistic about their findings.       More than just having a good grade to pass the entire course, students who are involve in this course must have to show exceptional discipline and performance projecting genuine concern to every patients that they meet. They should be professional in all their dealings, honesty and responsibility is its utmost care. During their course they are also taught about personal and work ethics by following the rules and regulation set by their disciplines and the government.         Everything that is mentioned above about dealing with their major subject and characteristic development must be met to be an effective respiratory medical professionals and it all starts with their study habit and conditional development that they can achieve, this means that they must be really serious and passionate about the entire course and not just a child play or professional demeanor.       In their program may also include a mastery and development of patient’s interaction and assessment. They can do this by simply talking to patients attentively about how they feel; they must also be proficient in collecting the necessary data so as to easily identify the patients. During laboratory, the students must learn to perform cardiopulmonary procedures since this is one of their major subject and after the series of test, they must learn to evaluate their own recommendation and results.       Clinical and laboratory confidentiality they must need to learn is not to divulge their findings to other people rather than those who are concerned; this has always been the error that is intentionally done by greedy professionals in exchange for something. Students must not answer the questions of patients if they are not authorized to do so, they should remember that a wrong premise might cause a more serious conditions on the part of their patients. If they cannot answer such question they will need to ask the authorized medical professionals or other person who are qualified to do so.       Cleanliness of equipment is a must, so as not to perform additional complication on the part of the patients and all the necessary tools must be sanitized, they must learn to perform proper hygienic practice about their equipments that they will use. All the materials that they have used should be properly be dispose or incinerated accordingly so as to prevent environmental pollution. Basic first aid therapeutic performance must also be practiced carefully including basic treatment, chest compression, intensive care and more. As a student they usually function as an assistant so as to master their entire course with a qualified professional.              In order to become an aspiring respiratory medical professional they must also complete the general requirement including academic excellence, in fact there should be no major or minor subject although they are required to master the specific subjects. A few more study habit recommendation that they need to encompass would be to follow a chain of command even they are just a students, this will prepare them to act professionally.        Students must aim to get an accreditation in Certified Respiratory Therapists or Registered Respiratory Therapists to gain and practice the most of their opportunities; they can also work in clinics and home care if they preferred to do so. Credit:ivythesis.typepad.com

Study Habits of the Respiratory Students in thier Major Subjects

STUDY HABITS OF THE RESPIRATORY STUDENTS IN THEIR MAJOR SUBJECTS Respiratory diseases are medical terms for various type of resp...

Diversity

Diversity

There is much to be concerned with especially when presented with such a case. As a nurse, my first concern will, of course, be the medica...