Research Articles Base

MANAGEMENT OF ANEMIA

MANAGEMENT OF ANEMIA IN RENAL PATIENTS   Introduction               Anemia is a serious medical condition which manifests in renal patients. Management of anemia in these patients is a collaborative effort which involves the general practitioner, the nephrologists, the specialist and the nurse. This paper will look into the roles these healthcare professionals play in the management of anemia.   Body   Renal failure can either be acute or chronic. Acute renal failure is the clinical condition associated with rapid, steadily increasing azotemia, with or without oliguria. The causes of renal failure can be grouped into three diagnostic categories: prerenal (inadequate renal perfusion), postrenal (obstruction), and renal. Prerenal and postrenal are potentially reversible if diagnosed and treated early, and some of the causes of primary renal injury which result in acute tubulointerstitial nephropathy are also treatable, such as bacterial infections, drug reactions, and metabolic disorders.             Initial evaluation of acute renal failure should seek reversible or specifically treatable causes of acute renal failure. Bladder neck obstruction is probably the most common cause of sudden, and often total, cessation of urinary output, especially in older men. A preceding history of difficulty in voiding is frequently given.             Chronic renal failure on the other hand is the clinical condition resulting from a multitude of pathologic processes which lead to derangement and insufficiency of renal excretory and regulatory functions (uremia). Chronic renal failure may result from any cause of renal dysfunction of sufficient magnitude.             When disease causes kidney failure or otherwise compromises the ability of the kidneys to remove toxic materials from the blood and maintain fluid, electrolyte, and acid-base balance, therapeutic dialysis by diffusion across a semipermeable membrane may be used. The patient’s own peritoneum or a machine using a synthetic semipermeable membrane such as cellophane may be used – peritoneal dialysis and hemodialysis, respectively.             Anemia is a frequent problem in patients with renal failure especially those in end stage and in chronic kidney disease (CKD) who are not yet receiving dialysis and can lead to major health complications if left untreated. The successful management of these patients entails repletion of iron stores, often through use of intravenous iron, particularly in patients receiving erythropoietin therapy. To encourage patient compliance with anemia management protocols, the nephrology nurse can play a key role in patient education in reducing barriers to proper management and in raising the awareness of the benefits of treating this condition (, 2001).             Nurses play a key role in helping to maintain Hb levels in the range recommended to mitigate anemia-related risk factors in both predialysis patients and those with end stage renal disease (ESRD). This is actually a situation which calls for a team approach comprising of the nephrologist, general practitioner, specialist and the nurse. Additional progress in anemia management can be obtained by understanding, the importance of early diagnosis and treatment of iron deficiency. Several factors contribute to iron deficiency in renal failure patients. First, observations with patients in the predialysis period, on hemodialysis, and on peritoneal dialysis suggest that intestinal iron absorption is reduced during ESRD. Poor absorption of iron can lead to the depletion of both circulating iron and iron stores, which is referred to as absolute iron deficiency. It has been suggested that low iron absorption in these patients may be explained by the intestinal mucosal changes that develop with uremia, including changes in activity of certain digestive enzymes–decreased activity of dipeptidases and increased activity of disaccharidases. Intestinal inflammation with associated histologic alterations may also be related to low iron absorption. Erosions and ulcers are additional gastrointestinal complications that often develop during ESRD. These are associated with gastrointestinal bleeding, which may also contribute to the development of iron deficiency. In hemodialysis patients, significant blood loss may also be caused by blood remaining in the dialyzers and dialysis lines postdialysis (, 2002). All patients returning to the dialysis facility following hospitalization should be immediately assessed to determine their clinical status. This process should include both a complete review of hematologic parameters and an individualized assessment for the presence of comorbid conditions that could affect hemoglobin (Hb) levels either acutely or chronically (, 2004).             Anemia may be aggravated during hospitalization, and patients returning to the dialysis facility may present with Hb levels that are significantly lower than baseline. Clinical data indicate that anemia can persist after hospitalization, with some patients requiring up to 6 months to regain preadmission Hb levels. To optimize anemia-related outcomes, a special approach to minimize post-hospitalization anemia may be warranted. Nursing interventions to proactively manage comorbid conditions, modify the anemia management prescription before hospitalization, and/or initiate a Rapid Ramping approach afterward can often minimize the severity of any decrease in Hb while shortening the time required to reaehieve targeted Hb levels (2004).             Proactive nursing interventions, including appropriate patient assessment, timely initiation of therapy, and individualized dose calculations, can help ensure that patients attain and maintain targeted Hb levels. The anemia manager should monitor the trends in Hb levels and note the increase after weeks of therapy; iron parameters should remain within the targeted range. Assessment should be negative for other conditions that may contribute to a low Hb, and if the Hb levels rose, the Epoetin alia dose should be gradually decreased to the prehospitalization level of 80 Units/kg TIW. The Hb should be restabilized weeks after discharge (, 2004).             The iron status of patients with renal failures should be evaluated on a regular basis during both the predialysis and dialysis periods, since these patients are at risk for developing iron deficiency (, 2002).             The role of the nephrology nurse in the anemia management of ESRD patients has been reviewed previously. Nephrology nurses often play a key role in managing patients with CKD. Because of recognition of the importance of active management of CKD patients at earlier stages in the disease practice, more CKD patients are likely to be referred to nephrologists before they need dialysis (, 2001). The advanced practice nurse, who is functioning as a physician extender, is more likely to work with patients in the predialysis setting than the nephrology nurse in standard practice who is usually involved with dialysis management. The advanced practice nurse may fulfill essential roles in identifying CKD patients at risk for developing anemia and managing the iron and EPO requirements of these patients (e.g., laboratory assessments of iron and hematology indices, prescriptions of therapies, etc.) (, 2001).             However, as more patients are being cared for by nephrologists at the predialysis phase, the nephrology nurse in the standard setting is likely to have increased contact with CKD patients. Nephrology nurses who do not oversee the direct medical management of CKD patients may still play vital roles in identifying anemic patients, promoting compliance, educating patients and health care personnel, and administering therapies. These functions are essential because several barriers exist to optimal anemia management in the CKD patient. For instance, patients and care providers may not understand the importance of anemia management and may question whether it is worth bringing CKD patients into the office weekly for injections. Nephrology nurses can communicate the importance of anemia management over the long term and assure patients about the safety and efficacy of the available therapies. Reimbursement for EPO may involve a great deal of red tape, even though it is an important therapy. The health care team must be unified in its commitment to overcoming the barriers to these interventions (, 2001).             Early identification and aggressive treatment of anemia in CKD patients may improve patient outcomes such as cardiovascular function, quality of life, and morbidity/mortality. There is a need for greater awareness of the importance of early intervention. Nephrology nurses have assumed increased clinical responsibilities within today’s practice setting, and their role in managing CKD patients may increase in the future. Nephrology nurses can have a major impact on the clinical outcomes of CKD patients, primarily through patient education and improved patient compliance (, 2001).  (, 2002).             Documentation of anemia-related assessments, interventions, and outcomes is an integral component of proper anemia management for patients with ESRD. In addition to promoting vital communication among medical professionals, documentation helps fulfill regulatory, legal, and payer reimbursement requirements, thereby ensuring that nursing contributions to patient well-being are recognized and that access to care is preserved (2003).             It is important for nephrology nurses to understand the relationship that exists between renal disease, cardiac disease, and anemia. Even mild cases of chronic kidney disease (CKD) have been associated with an increase in adverse cardiovascular outcomes. And anemia, which can result from both CKD and congestive heart failure, has been shown to exacerbate the adverse consequences of these conditions. An early, aggressive correction of anemia in patients with CKD can be implemented to break this cycle and stop disease progression. Studies have shown that anemia correction improves both cardiac and renal function and can result in increased hemoglobin levels, decreased number of hospital days, and improved quality of life. An effective strategy for managing anemia in patients with renal disease and comorbid cardiovascular disease includes the administration of both recombinant human erythropoietin and intravenous iron. In addition, the nephrology nurse plays an integral role in managing anemia and improving outcomes in these patients. Therefore, the nephrology nurse should have an increased awareness of the link between anemia and renal/cardiac disease as well as available treatment options (, 2005).   Recommendation and Conclusion               Anemia has long been recognized as a serious health problem in patients who have renal failures, especially those requiring dialysis. Successful treatment of anemia (i.e., increasing the hematocrit [hct] towards normal) in such patients is associated with reduced morbidity/mortality and significant improvements in cardiovascular and brain function as well as quality of life.             Although recent data indicate that the current anemia management protocols are resulting in good patient outcome, health care providers can still improve patient health by more aggressively addressing the problem of iron deficiency. A good starting point would be to establish a simple iron deficiency management protocol that involves early detection and treatment during both the predialysis and dialysis periods. Clinicians can also improve the outcome of iron deficiency by optimizing iron therapy. The administration of safe and effective IV iron supplements, close monitoring of iron and hematologic parameters, and maintenance IV iron therapy will help clinicians achieve good patient outcome. Taken together, improvements in anemia and iron deficiency management will ultimately improve patient health and quality of life and may also reduce financial burden.           REFERENCES   Credit:ivythesis.typepad.com

MANAGEMENT OF ANEMIA

MANAGEMENT OF ANEMIA IN RENAL PATIENTS Introduction Anemia is a serious medical condition which manifests in renal pat...

Managing Change: Case Analysis – Bottled water back to tap water

INTRODUCTION   Ideally, there can be intervention of certain change that denotes a failed remark and that the process pointing to it are quite not easy to handle in order to achieve a better change process. This particular report deals to the underlying situation of bottled water usage that has been affecting the lives of the Hong Kong people and to the environment as well and that it is just right for the Hong Kong government to impose action plan for considering back again the consumption of tap water into the Hong Kong households. Change and its underlying assumptions do take place as part of the business nature that may require an achievable success. Truly, studies made by various authors and observations by people, it can be that the presence of bottled water nowadays implies a hot issue as it affect the environment in a serious degree of concern. The report considers diverse elements and or factors upon the identification of change process in reflection to certain change related models such as those proposed by John Kotter and Kurt Lewin also, there includes critical evaluation or analysis as to why the Hong Kong government should be knowledgeable at the same time must be aware and provide actions, as ideal solutions upon encouraging as well as persuading the Hong Kong people and the general public to basically go back to using tap water instead of bottled water.         BODY   MOOD OF CHANGE – UNDERLYING PROBLEM   The problem can be based on the following content information:   Amicably, it can be quite hard to argue that, waste management has become huge in HK as well as in the world as with certain landfills growing to enormous sizes and recycling rates remaining low in specifications. Thus, numbers of plastic bottles being produced by bottled water industry and was discarded by consumers do exacerbate the problem. Besides the sheer number of plastic bottles produced each year, the energy required to manufacture and transport these bottles to market does drain the limited source of better fossil fuels. Moreover, it can be that bottled water companies for example in Hong Kong, due to their unregulated use of valuable resources and their production of billions of plastic bottles have presented significant strain on Mother Nature herself. It seems there is no feasible solution to the underlying problem as bottled water industry cause harsh strain on HK people as well as the environment but solutions to the damage may possibly lessen the quality of water in form of bottles. Bottled water then, is clearly not healthier or purer alternative to tap water and can be outrageously expensive when compared to costs of tap water gallon. So, if one HK household is choosing only between tap water and bottled water, it can adhere that tap water is much economical and the healthier choice but, despite certain assertion, tap water does not remain without problems at all. The water filters remove dangerous contaminants than any purification method, and uniquely design to work with such treated water and because water filters use no more energy than is already required to propel water through for instance,  home’s plumbing system, circumventing several environment issues posted within the bottled water industry. (Cited from, Golub, 2001; Potera, 2002) Meanwhile, there is significant and negative impact from bottled water industry on the environment. From millions of plastic bottles in landfills to the fuel costs of manufacture and transportation, bottled water is creating more environmental problems every year. World Wide Fund for Nature indicate that approximately 1.5 million tons of plastic are used in the bottled water industry every year, many of these bottles are recycled by conscientious consumers and most are not and are ending up into over-burdened landfills. (Cited from, Hession, 2006) Furthermore, there is the environmental cost of manufacturing and then transporting the nearly 100 billion liters of bottled water each year. There can be concept of paying for water to be bottled and then shipped in miles and that begins to appear quite absurd and there incurs poor use of Hong Kong natural resources. According to Ann Hession (2006), “tap water is far less expensive than bottled water, but it has its own drawbacks as lead, chlorine, herbicides and pesticides are commonly found in tap water”.     In addition, phthalates contained in plastic will leach into the bottled water, thus adding even more contamination to the water. In other words, bottled water is not guaranteed to be any safer than filtered water to start with, and after phthalate contamination from the plastic, it will in fact be even less safe for you and your family. Unfortunately, most people consuming bottled water are completely unaware of these unpleasant facts. Certainly the bottled water companies are not going to educate their customers about the hidden negative effects of their products. It is hard to imagine an intelligent consumer continuing to regularly consume bottled water once they have become aware of both the uncertainty of the quality of bottled water and the enormous negative environmental impact of the whole industry.   Furthermore, there can be indication of resistance to change in such factors as brought about by the presence of self interest among the HK people as it is essential for the HK people to see alternative ways in reducing the consumption of bottled water in order to save the environment from becoming ill seriously implying reasons to take part of the matter – to integrate action (Cited from, Trader-Leigh, 2002 p. 9) Aside, can be due to habitual reality centering on convenience option brought by bottled water usage as true that the HK region is fast as a globally inclined society that can buy things so easy and the convenience of saving time and effort that is why people are using bottled water for drinking purposes instead of using tape water. It is because of status approval that serves as a conformity icon that a one person drinking bottled water is considered “in” into the society where he belong   It is ideal for the HK government to be able to educate majority of the customers and thus provide suggestions that it is still safe enough to drink tap water given the fact that certain precautions should be fully understood and is more environment friendly as compared to bottled water which can be too costly at times. Then, the quality of water intake should also be in high appreciation as it assumes healthy lifestyle to the HK people as there can be no assurance that bottled water is 100% pure and clean water .In addition, psychological impact is also a factor for resistance as the said factor address perceptions of threat as well as social status in business as the fact that HK people who patronize the idea imposed by bottled water don’t want to embrace change and is not open to the idea of returning back to tap water event Hough the reality tells them that it is expensive but some people don’t mind the situation forgetting that environment do suffer a lot. The resistance to change is shown if the change pattern has not been fully crafted and that people sometimes are self centered individuals. (Cited from, Trader-Leigh, 2002 p. 11)   Thus, there also affected by the presence of marketing stance geared towards the seller power, manufacturer incentive in which there is saleable business reality to bottled water and that tap water can hamper the success and growth of the business. Then, having the desire to convince the HK households to neglect the use of bottled water and to return back to using tap water it is appropriate for the HK government to impose a specific budget for realizing such campaign drive explaining to the people why is it a must to save the environment from dying especially when it comes to water resources in HK. Thus, the HK government can plan as well as carried out better and conventional water process system maybe by putting up machines to clean tap water deeply in order to come up a safe and healthy drinking water in places wherein residences have easy access to the water without spending too much effort and money. Thus, since inconvenience do take place on the part of the consumers maybe water drinking fountains are possible and maybe put in HK public places or places wherein there is crowd like for example, four drinking fountains around HK national park and HK Disneyland and impose certain laws and regulations with regards to bottled taxes in this manner, probably the HK people will realize the importance of embracing alternative options when it comes to water consumption.      Analysis OF Stakeholders   Stakeholder analysis play crucial role for alleviating the change process that the suppliers and or sellers is basically against the change from bottled to tap water next, HK customers may not support the alternative as it may be inconvenient on their side. Also, HK government the need to explain as well as propose to the HK government certain change drives from a possible bottled water to tape water, environment affiliates does agree turning back tape water upon reducing plastic bottle use that has a negative outcome and lastly, the HK general public probably supports the initiative given the fact that the HK government can solve utmost concern and how educated they were in changing their attitudes and habits. Henceforth, HK households are also consumers and that changes may affect them positively or negatively and the integration of business to consumer domains will be at risk same also with the business to business system since, the possible termination of the bottled water purchases in the HK market industry does incorporate a direct effect on bottled water suppliers as well as several sellers and in turn, it can be that high job cut offs are present and some will lose their jobs mostly, those income depends on the bottled water industry as the truth that bottled water sales were dropping and that the presence of expensive tax rate per plastic bottle upon the reduction of business market revenues thus, linking towards indication of lifestyle inconvenience to the HK customers in general.     MODELS FOR CHANGE There incorporates actual state of change from bottled water consumption to tap water consumption and it is a must to identify and determine particular area of change within change models proposed by Kotter and Lewin respectively. Then, the following steps to change can be executed in such ideal plan of returning back to tap water and terminate bottled water usage that cab be effective when dealing with HK people as consumers of the market also and desirable change paradigm should be present as Kurt Lewin addresses successful change ways that can be useful for the stakeholder as part of the bottled water market in HK and the one related model point is the unfreezing mode found within Lewin’s Model as it is important that the HK government and its people should knowingly establish good relationship with business stakeholders and there can be educating of water consumers and be able to negotiate with business markets assuming that the plan of tap water usage do not affect deeply in terms of the supplier and seller value. The unfreezing the present level of performance upon establishing better relations to the HK people, help to realize behavior that are not effective and control change resistance.   Aside, Lewin also state that, “to break open the shell of complacency and self-righteousness it is sometimes necessary to bring about deliberately an emotional stir-up.” (1948, 1951 p. 654; 822) On the other side, Kotter’s model suggest that there is ample need to establish urgency as it is a must for the people to take care of the environment as urgency posit that HK government should do something as early as now before its too late to save the environment and hamper the balance niche and ecosystems as deemed possible that the ideal change should be supported by good planning and vision and be integrated by communication coherence and the role of law empowerment within the susceptible risks involve when actual change to tap water use from bottled water does take place in majority and the provision of updates of the needed change pattern within innovative approach.   change IN Leadership Truly, it can be that meaningful and acceptable agreement should be realized and must be decided by the HK government and certain involved sectors dealing to bottled water businesses and the advocates of tap water campaign drives as there should be assumption posits towards people motivation and that returning back to tap water usage would not mean to totally disregard bottled water consumption it can be that certain limitations within the market is a must to truly protect both sides of the matter and that people may not be completely divulge themselves in patronizing bottled water and take in ample consideration and awareness of trying to consume tap water given the fact that it is safe to drink especially those household with children. The change in leadership process is unique in every situation and it can be true that such leadership change is truly part of human life and continues to challenge people from all walks of life and become critical for HK government to promulgate better water management and to cope with the changing times. Thus leadership change and transformation can be a good source of putting in government plans of turning back tap water consumption into effective reality so that the desired route of transformation can be meaningful enough upon creating and reinforcing better commitment and by helping workers believe in the effort by engaging into practical options. The mind-sets and behavior in action do provide encouragement in supporting behavior ways. The change should be ideal and must be placed with strong government campaigns that would give precise information to the general public that it is much good to use tap water as compared to bottled water for one, it is environment friendly and less expensive.    CONCLUSION   In conclusion, therefore it is amiably essential for the HK government to help in the changing reality when it comes to the water consumption of the HK households and be able to educate them that environment should be their top priority for them to have a sustainable home grounds that they can utilize safely and soundly. Integrating factual assumptions that tap water is far better than bottled water in its general function and process and that such plan is an important facet for the HK government to consider like for instance, the building of alternative water systems that cleans tap water and make it a clean drinking water. Thus, change models should incur vital part in the process as there can be sense of urgency to adapt change upon caring the environment despite possible resistance among the HK households as well as the establishment of good stakeholder relations along the way.  Then, certain ideal recommendation should take place in the situation as such change must be based on communication channels of informing the people about the reality of such issues involved in understanding matters of water consumption and management and the providing of better outlook monitoring and the need to impose more laws on water processes in HK. Aside, the HK government must continue to surge awareness regarding tap water safety and cleanliness by possibly involved in such educational advertisements about water and its relation to nature, the need to basically augment protection of the environment by utilizing better water systems. Thus, HK government should understand that people are social beings and will adhere to culture norms and values and to execute certain rules that is not manipulated by the business market sectors who has influence over government decisions.        REFERENCES     Aiken, C. and Keller, S. (2007), The CEO’s Role in Leading Transformation. Management Quarterly Summer 2007 pp. 30-39   Golub, Catherine. (2001). Liquid assets: Is bottled water really better than what’s on tap? Environmental Nutrition, 24 (9)   Kotter, J.P. (1995), “Leading change: why transformational efforts fail”, Harvard Business Review, , pp.59-67   Lewin, K. (1935) A dynamic theory of personality. New York: McGraw-Hill.   Lewin, K. (1948) Resolving social conflicts; selected papers on group dynamics. Gertrude W. Lewin (ed.). New York: Harper & Row, 1948.   Lewin, K. (1951) Field theory in social science; selected theoretical papers. D. Cartwright (ed.). New York: Harper & Row   Nickols, F. (2003), Four Change Management Strategies. Distance Consulting   Potera, Carol. (2002). The price of bottled water. Environmental Health Perspectives, 110 (2). Shermer, Michael. (2003). Bottled twaddle. Scientific American, 289 (1)   Hession, A. (2006), The Bottled Water Industry and Its Effect on the Environment Published: 11/27/2006 at: http://www.buzzle.com/articles/bottled-water-industry-effect-environment.html   Trader-Leigh, K. (2002), Case study: identifying resistance in managing change. Journal of Organizational Change Management; 2002; 15, 2; ABI/INFORM Global pp. 138 +     Credit:ivythesis.typepad.com

Managing Change: Case Analysis – Bottled water back to tap water

INTRODUCTION Ideally, there can be intervention of certain change that denotes a failed remark and that the process pointing to it...

CARCINOMA OF THE TONGUE CASE STUDY

ac 1. Explain fully the patient’s condition and why surgery was indicated. Additionally, explain why cefoxitin was prescribed and administered. Carcinoma of the tongue is an oral cancer that is characterized by an ulcerating malignant tumor, usually on the side of the tongue, consisting of scaly (squamous) cells. The tumor may spread to the lymph nodes on the same side of the neck. Squamous cell carcinoma is the most common type of oral cancer. Nearly 40% of squamous cell carcinomas affect the lower lip; many of the remainder affect the floor of the mouth or the tongue. These cancers form a hard lump or a firm-bordered sore (ulcer) that may bleed intermittently. Affected areas may appear white, red, or mixed white and red and can be smooth or raised. The commonest histology among tumors of base of tongue is squamous cell carcinoma (> 90%), with salivary, gland tumors comprising small subsets (1-2%). Epithelial-myoepithelial carcinomas have traditionally been categorized under “malignant mixed tumors”, but the term has now been separated and added to the second edition of the World Health Organization’s histological classification of salivary gland tumors. Other synonyms of epithehal-myoepithelial carcinoma include epithelial carcinoma, myoepithelial carcinoma and clear cell carcinoma of salivary, gland origin.   A biopsy is essential. Treatment for lesions greater than 2 cm is surgical excision or irradiation. Surgical resection is an effective treatment for primary squamous cell carcinoma arising on the tongue. It is advised that the malignant body be removed from the tongue as this can spread to the surrounding areas and lymph nodes. Cefoxitin was prescribed and given to the patient as this drug belongs to a group of antibiotics called the cephalosporins. Their action is to kill bacteria by interfering with the ability of bacteria to form cell walls. The bacteria therefore break up and die. Cefoxitin is given by injection or infusion, and is generally used in severe infections or before an operation to prevent infection after surgery. 2. Discuss in detail the reaction of this patient to the drug.             The drug cefoxitin has some common side effects. But what the patient had after intravenous administration of cefoxitin is an uncommon side effect which is low blood pressure or hypotension, wheezing over both lung fields and urticaria.             Various antibiotics including cefoxitin may alter the balance of the body. Generally, hypotension or low blood pressure is defined as a systolic BP of 90 mm Hg or less that causes light-headedness, visual disturbances, decreased level of consciousness, syncope, decreased urine output, and, ultimately, shock. Someone who has a low BP without these signs and symptoms isn’t considered to have hypotension.             Untreated hypotension can lead to shock and organ failure, so promptly assess the cause, type, severity, and duration to prevent ischemia and tissue death. Successful management calls for the following measures. 3. Explain why epinephrine, dexamethasone, diphenhydramine, dopamine and fluids were prescribed. Include in your account the mechanism of action of these drugs.             Epinephrine has a greater effect in stimulating beta receptors and also has greater effect on cardiac stimulation. Epinephrine causes weak constrictions of the blood vessels in the muscles. Epinephrine thus raises the arterial pressure to a lesser extent than norepinephrine but increases the cardiac output more..             Dexamethasone is a glucocorticoid which is synthetic and is thirty times as potent as cortisol. The intense glucocorticoid activity of this synthetic hormone, which has almost zero mineralocorticoid activity, makes this an especially important drug for stimulating specific glucocorticoid activity. The action of glucocorticoids includes regulating multiple metabolic and developmental processes and they also play a vital role in the maintenance of basal and stress-related homeostasis. Diphenhydramine is an antihistamine with anticholinergic (drying) and sedative properties that is used to treat allergic reactions. Histamine is released by the body during several types of allergic reactions and–to a lesser extent–during some viral infections. When histamine binds to its receptors on cells, it causes changes within the cells that lead to sneezing, itching, and increased mucus production. Antihistamines compete with histamine for cell receptors; however, when they bind to the receptors they do not stimulate the cells. In addition, they prevent histamine from binding and stimulating the cells.             Dopamine is a chemical which is produced by the body and plays in important role in brain and nervous functions. Dopamine can be supplied as a medication that acts on the sympathetic nervous system, producing effects such as increased heart rate and blood pressure (to counter the hypotension experienced as a result of the administration of cefoxitin).             Basically, the actions of all these drugs and fluids are geared towards returning the body into its normal states.   4. Explain in detail why pulmonary edema developed in this patient.             When the heart is not pumping blood forward, it must be damming blood in the blood vessels of the lungs or in the systemic circulation. This increases both the left and the right atrial pressures and leads to increased capillary pressures, particularly in the lungs. The acutely diminished cardiac output as a result of the cardiac injury leads to diminished blood flow to the kidneys, and the kidneys fail to excrete enough urine. This adds progressively to the blood volume and, therefore, to the congestive symptoms – pulmonary edema.   Credit:ivythesis.typepad.com

CARCINOMA OF THE TONGUE CASE STUDY

ac 1. Explain fully the patient’s condition and why surgery was indicated. Additionally, explain why cefoxitin was prescribed and admin...

The Pros and Cons of a May-December Love Affair

The Pros and Cons of a May-December Love Affair             “Age doesn’t matter”. This is one of the most commonly used slogan of lovers for like a century. But, we were used to seeing man as the older one when it comes into relationships. And, when he’s older than the woman, he must not exceed ten years older than the woman. But how did this rule in relationships come to occur? Is it only me who have never seen the constitution and by-laws of lovers? Or, is it everyone?             Yes, it is everyone who has never seen that kind of constitution and by-laws because it doesn’t really exist. It is only our elders who make those kinds of norms, consequently erroneously believed by most of the following generations.             As we try to analyze it, there are only a few reasons why the society looks down to the May-December affairs. When one is much older than the other in the relationship, taking for example: the woman is older than the man for eleven years, there would always be some instances that their likes and dislikes don’t meet up. If the guy of twenty-plus dates a woman at her thirties, they couldn’t go gimmicking together like hanging out to the clubs because of the thirties already see clubs not ideal for their age and that those places are so noisy. In that case, the guy would argue with the woman about her not acceptance of his world. He may misunderstand the woman’s idea about his going out.             Another con in a May-December relationship is that the older one, especially when she’s lived a good reputation gets very timid about the relationship to the public especially in the beginning because she stereotypes that everyone doesn’t agree with them going out, having the big difference in their age. That would really be a conflict.             Also, in this relationship, there would always be times that the older one is the captain of the ship and that she must always be the one to decide because she’s the one who’s wiser in the duo. This is a kind of control of the relationship that is difficult to handle. Although the younger one wants to do something for the relationship, there would be moments that he’ll be left like an immature and irresponsible being, since he’s younger. In that case, that would cause the younger partner to become dependent on his older partner and their relationship. That would cause him to knock his self-esteem off.             Most notably, the cruelest part of the relationship would likely to happen. That is for the younger one to look for his age or even younger. Since, he is with an older one, there is always a possibility that youth would tempt him for youth. And since the elder sees the relationship more stable because she’s a t the age of seeing it as it is, she’ll stay at her place to please her guy, leaving her the possibilities that a dim light triggers.             But then again…”age doesn’t matter”.             For those who are in this relationship, they see this kind of togetherness as unique. Yes, it may be because not everyone sees the essence of a May-December relationship. But this relationship may be sweeter than any other thing in this world.             Every man has a boy within himself. He hides it because of machismo. But, when he’s with the person he loves, he tends to be more secure and he reveals himself more openly. That’s the way every man is. Then, in a May-December relationship, she is more likely to display some motherly love to her man, whether she understands the need of every man or not. Every man, though they admit it or not, always wanted that there’s someone whom they know could act as his mother and show her love unconditionally towards him.             Also, being unaccepted by the majority because of the norms and misconceptions, the duo involved in a May-December relationship try so hard in order to be accepted by the public. Most of them don’t really care if they are termed as eccentric, but others, since they’re seen as part of the society, still struggle so hard in order for them to be blessed by the public (although they know that it doesn’t really matter at all) and especially by their friends and love ones. In this sense, they do their best effort for each of them to stand strong and keep the faith burning in each one’s heart.             A May-December affair may sound absurd to most of the people, but we should not be that chary of what the people involved are happy about. They are humans, and there never a rule that had ever been established or acknowledged about the age of couples. As long as both individuals involved in the relationship are at their right legal age to decide, they are, by all forces of nature, have the right to love and be loved in return. Credit:ivythesis.typepad.com

The Pros and Cons of a May-December Love Affair

The Pros and Cons of a May-December Love Affair “Age doesn’t matter”. This is one of the most commonly used slogan of lover...

ESSAY: ( RENAL WARD )

Literature review relevant to your clinical setting (Renal ward)               Normal elimination of urinary or renal wastes is a basic function that most people take for granted ( & , 2004). When the urinary system fails to function properly, virtually all organ systems will be eventually affected. For this reason, interventions designed to combat renal difficulties and failures are of paramount importance in my placement which is in the renal ward. As a nurse in the renal ward, understanding and a sensitivity to all clients’ needs are important.             For this paper, a specific clinical scenario that usually happens in the renal ward is chosen. This condition is urinary tract infection as a result of the catheterization. The reason for choosing this clinical condition is that this is very common yet if left untreated can pose serious harm to the patient.   Body             Urinary tract infections or more commonly referred to as UTIs are responsible for more than 7 million physician visits a year and are the most common hospital-acquired (nosocomial) infections in many countries worldwide (, 2002). Many cases of urinary tract infections result from catheterization or surgical manipulation. Although several different microorganisms may cause this condition, Escherichia coli remains the most common causative pathogen, responsible for 80% of uncomplicated infections. Bacteria in the urine or bacteriuria may lead to the spread of organisms into the kidneys and bloodstream, leading to urosepsis ( & , 2002). Microorganisms most commonly enter the urinary tract through the ascending urethral route. Bacteria inhabit the distal urethra, external genitalia, and vagina in women. Organisms enter the urethral meatus easily and travel up the inner mucosal lining to the bladder. Women are more susceptible to infection because of the proximity of the anus to the urethral meatus and because if the short urethra ( & , 2004). Catheter insertion is the primary risk factor for nosocomial urinary tract infections. Women and elderly patients are at increased risk for catheter-associated urinary tract infections, but several other risk factors exist. Pre-existing chronic illness, malnutrition, diabetes, renal insufficiency, and insertion of the catheter outside the operating room or late in hospitalization are each associated with increased risk of urinary tract infections (, 2005). In men, prostatic secretions that contain an antibacterial substance and the length of the urethra reduce the susceptibilities to urinary tract infections. Older adults and patients with progressive underlying disease or decreased immunity are also at increased risk ( & , 2004). In a healthy person with a good bladder function, organisms are flushed out during voiding. Residual urine in the bladder becomes more alkaline and is an ideal site for microorganism growth. Any interference with the free flow of urine can cause infection. a kinked, obstructed, or clamped catheter and any condition resulting in urinary retention increase the risk of a bladder infection. In the hospital setting, urinary tract infections occur as a result of catheterization. Each year, urinary catheters are inserted in more than 5 million patients in acute-care hospitals and extended-care facilities. Urinary tract infections are the second most common nosocomial infections in hospitals in Europe and the first in the United States (, 2001). Catheter-associated urinary tract infection (CAUTI) is the most common infection acquired in nursing homes and in hospitals, comprising more than 40% of all acquired infections. For centuries, the urethral catheter system consisted of a tube inserted through the urethra into the bladder and drained into an open container. The closed catheter system was developed in the 1950s and is still in use today (, 2000). UTIs are the most common nosocomial infection, accounting for 40% of all hospital-reported infections and affecting approximately 600,000 patients annually. Catheter insertion is the primary risk factor for nosocomial UTIs. Women and elderly patients are at increased risk for catheter-associated UTIs, but several other risk factors exist. Pre-existing chronic illness, malnutrition, diabetes, renal insufficiency, and insertion of the catheter outside the operating room or late in hospitalization are each associated with increased risk of UTIs. UTIs also add to the costs of care by prolonging hospitalization by 1 to 4 days and increasing the direct costs of treatment by an estimated 3 to 0 per infection (, 2005). They may involve a urosepsis, which carries a mortality rate that may be as high as 25 to 60%. They often occur in patients with an indwelling urinary catheter. The lumen and external surfaces of the catheter are the routes for bacterial entry into the bladder. For preventing infection, the maintenance of a closed sterile drainage system is described as the most successful method. A closed drainage system was described for the first time in 1928, and its benefit was appreciated much later (, 2001). Catheterization of the bladder involves introducing a rubber or plastic tube through the urethra and into the bladder. The catheter provides a continuous flow of urine in patients who are unable to control micturition or those with obstructions. It also provides a means of assessing urine output in hemodynamically unstable clients. Because bladder catheterization carries the risk of urinary tract infections, blockage, and trauma to the urethra, it is preferable to rely on other measures for either specimen collection or management of incontinence ( & , 2004).             The use of urinary catheters should be avoided whenever possible. Clean intermittent catheterization, when practical, is preferable to long- term catheterization. Suprapubic catheters offer some advantages, and condom catheters may be appropriate for some men. While clean handling of catheters is important, routine perineal cleaning and catheter irrigation or changing are ineffective in eliminating bacteriuria. Bacteriuria is inevitable in patients requiring long-term catheterization, but only symptomatic infections should be treated. Infections are usually polymicrobial, and seriously ill patients require therapy with two antibiotics. Patients with spinal cord injuries and those using catheters for more than 10 years are at greater risk of bladder cancer and renal complications; periodic renal scans, urine cytology and cystoscopy may be indicated in these patients (, 2000).   Recommendations             Build up of secretions or encrustation at the catheter insertion site is a source of irritation and potential infection. The nurses, in order to avoid such a situation, must provide perineal care and hygiene at least twice daily or as needed for a patient with a retention catheter. Soap and water are effective in reducing the number of organisms around the urethra. The nurse must not accidentally advance the catheter up into the bladder during cleansing or risk introducing bacteria.             In addition to routine perineal care and hygiene, many institutions recommend that clients with catheters receive special care at least three times a day and after defecation or bowel incontinence to help minimize discomfort and infection.             Maintaining a closed urinary drainage system is important in infection control. A break in the system can lead to introduction of microorganisms. Sites at risk are the site of catheter insertion, the drainage bag, the spigot, the tube junction, and the junction of the tube and the bag. In addition, the nurse has the responsibility to monitor the patency of the system to prevent pooling of urine within the tubing. Urine in the drainage bag is an excellent medium for microorganism growth. Bacteria can travel up drainage tubing to grow in pools of urine. If this urine flows back to the patient’s bladder, an infection will likely develop.             Suggestions for ways to prevent infections in catheterized patients are the following: <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Follow good hand hygiene techniques.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Do not allow the spigot on the drainage system to touch a contaminated surface.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Only use sterile technique to collect specimens from a closed drainage system.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> If the drainage tube becomes disconnected, do not touch the ends of the catheter or tubing. Wipe the end of the tubing and catheter with an antimicrobial solution before reconnecting.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Ensure that each client has a separate receptacle for measuring urine to prevent cross contamination.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Prevent pooling of urine in the tubing and reflux of urine into the bladder.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Avoid raising the drainage bag above the level of the bladder.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> If it becomes necessary to raise the bag during transfer of a patient to a bed or stretcher, clamp the tubing or empty the tubing contents to the drainage bag first.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Provide for drainage of urine from the tubing to the bag by positioning the tubing.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Empty the drainage bag at least every 8 hours. If large outputs are noted, empty more frequently.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Encourage fluid intake, if it is not contraindicated. Inclusion of cranberry juice has been shown to decrease the adherence of bacteria to the bladder wall and to catheter lumen.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Remove the catheter as soon as clinically warranted.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Tape or secure the catheter appropriately for the patient.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Perform routine perineal hygiene per agency policy and after defecation r bowel incontinence.</li> </ul>               Good health depends in part on a safe environment. Practices or techniques that control or prevent transmission of infection help to protect individuals, especially patients and health care workers from disease. Patients in all health care settings are at risk for acquiring infections because of lower resistance to infectious microorganisms, increased exposure to numbers and types of disease-causing microorganisms, and invasive procedures.             In acute care or ambulatory care facilities, patients can be exposed to pathogens, some of which may be resistant to most antibiotics. By practicing infection prevention and control techniques, health care workers can avoid spreading microorganisms to patients and fellow health care workers. In all settings, the patients and their families must be able to recognize source of infections and be able to institute protective measures. Patient teaching should include information concerning infections, modes of transmission, and methods of prevention. The first major advance for preventing CAUTI since the wide-scale adoption of closed drainage 35 years ago is the development of catheters with antiinfective surfaces. These advances should not be considered the final answer, however. Other technologies that should be pursued include new, more potent antiinfective materials; microbe-impervious antireflux valves; urethral stents; conformable (collapsible) urethral catheters; and vaccines for enteric gram-negative bacilli and staphylococci. Antiseptics are far more likely than antibacterials to confer greater resistance to surface colonization and not to select for infection with antimicrobial-drug resistant bacteria or yeasts. New surface technologies that release far greater quantities of ionic silver or other antiinfective agents into the aqueous environment contiguous to the catheter surface might even prevent CAUTIs caused by intraluminal contaminants (, 2001). Prevention of catheter-associated UTIs is more effective, particularly for indwelling catheters, than relying solely on antimicrobial agents. () The most effective practice interventions for reducing catheter-associated UTIs include identifying patients who no longer need indwelling catheters, considering other catheterization options or alternatives to catheterization, and providing patient and caregiver education when long-term indwelling catheterization is needed (, 2005). Reducing the time a patient is catheterized can be accomplished by systematic reminders to review the duration of catheterization for each patient. In addition to practice intervention, the choice of catheters and related equipment can also reduce UTIs substantially. Other methods of catheterization should he considered before inserting an indwelling catheter. Catheterization options are based on the reason for catheterization and the expected duration of need. Other options include condom catheters for males, suprapubic catheters for patients who require long-term indwelling drainage, and intermittent catheterization for patients with spinal cord injuries. Patients who must use an indwelling catheter should have a closed catheter system with a small catheter. Manufacturer’s recommendations for inflation and deflation, system maintenance, securing the catheter, and properly positioning the drainage bag below the patient’s bladder should be followed. Preventing encrustation and blockage are also very important. Following these steps and properly maintaining closed drainage catheter systems has been shown to substantially reduce the risk for UTI (, 2005).   Summary and Conclusion             Patient safety should be the number one concern before, during and after each procedure in any hospital. A detailed knowledge of the epidemiology, based on adequate surveillance methodologies, is necessary to understand the pathophysiology and the rationale of preventive strategies that have been demonstrated to be effective. In my area of work which is in the renal ward, the principles of general preventive measures such as the implementation of standard and isolation precautions should be reviewed. Urinary catheterization can cause many health problems. Alternatives to catheterization should be used whenever possible. Reduction of catheter-associated UTIs is based primarily on preventive infection control practices. The success of the nurse who practices infection-control techniques is measured by determining whether the goals for reducing or preventing infection are achieved. A comparison of the patient’s response, such as absence of fever or development of wound drainage, with expected outcomes determines the success of nursing interventions.     Reference Credit:ivythesis.typepad.com

ESSAY: ( RENAL WARD )

Literature review relevant to your clinical setting (Renal ward) Normal elimination of urinary or renal wastes is a basic...

Statistics Assignment :Why do some people like New York more than others?

Why do some people like New York more than others?   Problem: Do people who are living in New York City really “like” the place or they just wanted to be there because they “have to” do their family duties, job, education? Is there any significant difference between the likings of people to live in the city in terms of their gender, age, years in the city, education, love of living in city?  Based on the study of Milgram S. (1970), most people wanted to live in cities because it has the density and numbers to support all kinds of activities.  According to http://www.truehome.com, people tend to choose New York because of its capability to suffice the needs of different people.   Method: To evaluate the likings of the people to New York City, an anonymous survey questionnaire was given to 70 individual.  The said survey questionnaire are comprises of 21 good questions. Most of the items are about demographics of the respondents including their response if they “like to” or “have to” live in NYC.  From these 70 total population, 10 of it were randomly selected and to be evaluated in this paper.   Results: From the given survey report, 50% of the respondents stated that they “have to” live in New York City and another 50% of them agreed they really “like to” live in New York City.  The survey also justifies that because of various capabilities of NYC to give the needs of people, “they have” to live in the place. From the data gathered to 10 randomly selected respondents, 60% of them are males while there are only 40% of females. The average age of these subjects is 39 years old. Actually, 50% of them are college, 20% from high school and 30% who are in graduate studies. With regards to ethnicity of the surveyed subjects, 60% of them are black, 20% are white, 10% are Hispanic and another 10% of them are Asian. Through the use of ANOVA, this report also identifies the significant differences between the preferences of people with respect their demographics. Table 1 shows the summary of ANOVA with respect to their preferences.  From these results, we can say that there is no significant difference between the likings of people to live in New York with respect to gender, age, years in the city, education and the degree of their preferences if they love New York.   Discussions: The results of the analysis pertaining to preferences of respondents whether they “like to” or “have to” live in New York are presented in Table 1. In one-way ANOVA, each items of the total variation is partitioned into two components. Between Groups represents variation of the group means around the overall mean (Einstein, G. & Abernethy, K. 2000). Within Groups represents variation of the individual scores around their respective group means. Basically, .sig indicates the significance level of the F-test. Small significance values (<.05) indicate group differences (Einstein, G. & Abernethy, K. 2000). In our data, the significance level of most items are more than 0.05 except to love category. Actually less than 0.05 results signify that at least one of the regions differs from the others. From our results, it is evident to state that most people have to live in New York because of their love ones and not only because they just like the place. Their demographics such as gender, age, years in the city, education and the degree of their preferences if they love New York receives similar responses if they “like to” or “have to” live in New York City.  Meaning to say, their demographic profile has no significant effect to their preferences whether they “like to” of “have to” live in New York.   With regards to their view pertaining to City life and preferences, Table 2 and Table 3 described the break down of the responses of the respondents.  In Tables 2 and 3, the respondents were asked to rate each statements in accordance to their personal choice.  Table 2 described how the people like to live in New York.  From the results, it seems that majority of the respondents dislike to live in New York because of unpredictability of experiences and constant sounds in the city.  Apparently, the variable pertaining to fast pace change and streets full of people receives an average neutral response.  Actually, people like to live in New York because of people itself.  Meeting new people and ethic diversity present in New York City are reasons of most surveyed individuals to live in the city.   In accordance to the personal preferences of the respondents included in the survey, majority of them stayed neutral on each statement except to statement 3.  It states that “I like continually changing activities”.  Actually, the average response for this statement is agree.  Actually, these responses reflect that most of the surveyed respondents living in New York are agree or even disagree on the current lifestyle in New York.  To verify if the personal preferences of the surveyed individual is correlated to their city life the use of correlation statistics was initiated.  Table 4 shows the relationship of city life and personal preferences of the respondents.  From the average respondents in each category, the computed correlation value (i.e. r = 0.684) justified that there is significant relationship between the variables. Actually, the correlations table displays Pearson correlation coefficients, significance values, and the number of cases with non-missing values. Pearson correlation coefficients assume the data are normally distributed (Einstein, G. & Abernethy, K. 2000). The Pearson correlation coefficient is a measure of linear association between two variables. The values of the correlation coefficient range from -1 to 1. The sign of the correlation coefficient indicates the direction of the relationship (positive or negative) (Einstein, G. & Abernethy, K. 2000). The absolute value of the correlation coefficient indicates the strength, with larger absolute values indicating stronger relationships (Einstein, G. & Abernethy, K. 2000). Einstein, G. & Abernethy, K. (2000) stated that the correlation coefficients on the main diagonal are always 1.0, because each variable has a perfect positive linear relationship with itself. Correlations above the main diagonal are a mirror image of those below. In our data, the correlation coefficient for the variable is 0.684. Since 0.684 is relatively close to 1, this indicates that the variables are positively correlated. Moreover, the significance of each correlation coefficient is also displayed in the correlation table. The significance level (or p-value) is the probability of obtaining results as extreme as the one observed. Since significance level is very small (less than 0.05) then the correlation is significant and these two variables are linearly related. Meaning to say, as the respondents personal preferences increases in the categories described in Table 3, their likings towards living in New York also increases.   Aside from these findings, it is also discovered that those people who choose to live New York because they “like to” is also similar to the responses of people who “have to” live in New York with respect to City life and Personal preferences (see Appendix for t-test results).  Meaning to say, there is no distinction of responses whether they “like to” or “have to” live in New York with respect to City life and Personal preferences.  Although the group statistics table in Appendix, shows that most the respondents who chooses to live in New York because they “like to” is better compared to those who are living in the city because they “have to” (refer to mean values in group statistics).  Actually, the survey also justified that those people who love the city tend live in New York because they “like to”.  The survey shows that those people who live in New York because they “have to” only shows 4.20 mean responses in accordance to the degree of love in the city. While those people who live in New York because they “like to” shows expressive averages in terms of love in the city i.e. 7.20 mean responses.  From these results, we may say that those people who love to live in the city will live in New York because they “like to” and not they “have to”.         References:   Einstein, G. & Abernethy, K. (2000). Statistical Package for the Social Sciences (SPSS Version 10.0).          Greenville, South Carolina: Furman University.   Milgram, S. (1970).  The experience of living in the cities.  Science, 167, 1461-68.   http://www.truehome.com           Appendix         The Independent-Samples T Test procedure compares means for two groups of cases. The mean values for the two groups are displayed in the Group Statistics table. If the significance value for the Levene test is high (typically greater that 0.05), we may use the results that assume equal variances for both groups. On the other hand, if the significance value for the Levene test is low, we need to use the results that do no assume equal variances for both groups. A low significance value for the t test (typically less than 0.05) indicates that there is a significant difference between the two group means. If the confidence interval for the mean difference does not contain zero, this also indicates that the difference is significant. If the significance value is high and the confidence interval for the mean difference contains zero, then we cannot conclude that there is a significant difference between the two group means. Credit:ivythesis.typepad.com

Statistics Assignment :Why do some people like New York more than others?

Why do some people like New York more than others? Problem: Do people who are living in New York City really “like” the place or the...

HISTORY BEHIND REPRODUCTIVE HEALTH EDUCATION

HISTORY BEHIND REPRODUCTIVE HEALTH EDUCATION         There are many countries and regions around the world that have provided themselves different family planning and reproductive health and sexuality methods and preferences depending on their socio-cultural influences that is believed to be the basis of their education, basically the United States Agency for International Development (USAID) has been one of the most successful reproductive health education development promoter around the world. Officially they have launched the Family Planning Program from different countries including various states of Africa and certain countries in Asia. As early as of 1965 they have been promoting family planning methods so that family and population from various regions will be controlled they believed that families can have a better life through family planning.       They have envisioned such countries for growth opportunity if they can maintain their family they may be able to provide food, shelter and clothing to their children. USAID has become very successful in their promotion that they are able to reach mostly targeted success in other countries that they have visited. During their first few years of operation they focused on couples to have limited children according to their economic capability for safe parenthood and happy family living and controlled communities. They also believed that they can also protect women through controlled pregnancy, they have also advice couples to have an in between or time frame delayed before having another baby or they may use various contraceptive methods of their choice while doing so.       This method can also control population explosion that has become the problem of the government and by doing so the family can have good opportunities for education, employment and other social participation. The people themselves will be the primary contributors to economic growth by becoming socially responsible in building their own family. Within the next few years of their operations they have already introduced the use of modern contraceptive methods including pills and condoms although there have been criticism, negligence and resistance from different countries especially among the Asian regions who still exercise conservatism in fact there are religious sectors who still do not believe in this modern contraceptives and most likely they believe that this is an insult to their religious belief. In this instance and in the late 90’s USAID Family Planning has also became popular known as reproductive health.       In a formal institution history and timeline may show that as early as 1912 the National Education Association (NEA) has designed a training program to prepare teachers to include in their class sexuality in education During the 1940 the US Public Health Service has also participated in the development process and promotion that sexual education is urgently needed in the society and through these activities. In 1953 they have also attracted some schools including the American School Health Association to launch a nationwide campaign about sex education and its importance. Later in 1955 the American Medical Association follows NEA for their campaign. But only in 1960’s they have been noticed, this created a debate and controversies upon such inclusion in a formal institution like schools.       Such campaigns has not been easy from the start there were different points of view and hindrances that usually arise every now and then and it has become severe during the start of 1960’s to the early 80’s when various opponents have religiously attacked such programs especially among public and elementary schools. Conservative groups and religious sectors have battled it out over the reproductive health leaders who initiated such acts. Some organizations like The John Birch Society, Far right eagle forum organization and other opposition worldwide has joined together to argue over different topics, some even argued that sexual education may even promote increase in crimes and sexual participation among teen- agers that they may be taught to demonstrate their skills in a sexual acts in schools that suppose to teach them morality.       Most of them even condemn the use of contraceptives as another form of abortion and it is therefore illegal. But reproductive health advocates believed that such issues are irrelevant and they also believed that sex education may have even lessens sexual participation among young adults if they are properly guided. They believed that this will be the answer to the problem of the world about economic and social constraints that is now limiting our world about progress. From then on many issues about reproductive health or sex education has go beyond culture and influences that schools who believed in sex education may have included such topics in their subjects while some schools have diligently avoid this topics. Around the world this issues does not have any international standard and claims that is should be introduced in schools and government themselves will be the one to decide. The rage of religion and reproductive health educators has become a recurring trend in many countries until today.    Credit:ivythesis.typepad.com

HISTORY BEHIND REPRODUCTIVE HEALTH EDUCATION

HISTORY BEHIND REPRODUCTIVE HEALTH EDUCATION There are many countries and regions around the world that have provided themselves...