Category: Nursing

Article One

 

Title

 

Ely J. T. A., Mercury Induced Alzheimer’s Disease: Accelerating Incidence?

 

Purpose

 

The purpose of the study is to determine whether the mercury contained within amalgam restorations increased the likelihood of acquiring Alzheimer’s disease.  The study seeks to bring into light the connection between a condition called micromercurialism, a form of mercury poisoning following low-dose mercury exposure over a prolonged period of time, and amalgam. The study will attempt to support the controversial claim that micromercurialism is one of the main causes of Alzheimer’s disease.

 

Methods

 

The amount of mercury (Hg°) released from amalgams was determined using a Jeronome Model 411 Mercury Vaporizer Analyzer powered by a portable battery. Subjects used in the study were found in a meeting on mental illness and had either requested to participate in the study or consented to it. An initial mercury reading was obtained 30 seconds prior to a gum chewing session and then again after the gum chewing session (for this reading, the participant’s teeth was dried and the participant was asked to hold his or her breath for 10 seconds). By blowing air into the mercury vaporizer, the mercury level contained within the air sample could be determined and displayed as a digital readout. Mercury levels were compared before and after gum chewing (by blowing air into a mercury vaporizer) for two participants.

 

 

 

 

 

Results

 

The study supported the notion that mercury is released from amalgam restorations. Mercury vapour content post gum chewing was at least four times higher than that found before gum chewing. When an individual is chewing gum, mercury-containing vapour is produced in the oral cavity and the individual could then inhale this vapour. Other studies had similar findings; for example, one study-examining cadavers showed that individuals with amalgam restorations had higher levels of mercury in the nucleus basalis of Meynert as compared to individuals without amalgam restorations. It is suggested that perhaps amalgam results in increased incidence of Alzheimer’s disease because the presence of mercury induces the activity of mercury-inactivating enzymes. Mercury-inactivating enzymes have been implicated in slowing down natural neural processes, and thus may be responsible for causing Alzheimer’s disease.

 

Critique

 

Since the sample size was extremely small containing only two subjects, the results obtained cannot be extrapolated to the general population with a high degree of confidence. Increasing sample size would make the results obtained more reliable. Moreover, since the two participants used did not have Alzheimer’s disease, the study cannot conclude directly that mercury from amalgam restorations causes Alzheimer’s disease; rather the study can only claim that the mercury within amalgam restorations can be released into a vapour following chewing. To conclude that amalgam restorations result in increased incidence of Alzheimer’s disease, a long-term study would need to be conducted and the incidence of Alzheimer’s disease in this group would need to be significantly higher than that found in the general population. If empirical evidence supported the idea that amalgam restorations cause Alzheimer’s disease, it would permanently change how dentistry is practiced.

 

Conclusion

 

Using two mental health patients, the study showed that following chewing, mercury could be released from amalgam restorations into the air contained within the oral cavity. However, it cannot be concluded definitively, based on this study that the mercury contained within amalgam restorations causes Alzheimer’s disease. To be able to make such a bold claim, a long-term study involving many individuals with amalgam restorations would need to be conducted, and the incidence level of Alzheimer’s disease would need to be much higher in this group than in the general population to support such a claim. Moreover, part of the author’s claim that the mercury contained within amalgam restorations causes Alzheimer’s disease is based on other studies each using a different set of methods.

How can liver and renal diseases result in abnormal uterine bleeding (AUB)?

 

a.

They cause an imbalance in platelet aggregation.

 

b.

They result in an inability to adequately clear estrogen from the body.

 

c.

They cause thyroid dysfunction, which leads to bleeding abnormalities.

 

d.

They result in elevated prolactin levels, which lead to bleeding abnormalities.

 

 

What is now thought to be the most important causative agent in cervical cancer?

 

a.

PCOS

 

b.

Vulvar cancer

 

c.

Herpes simplex

 

d.

HPV

 

 

An initial or primary genital herpes infection characteristically lasts about:

 

a.

1 week

 

b.

3 weeks

 

c.

1 month

 

d.

6 weeks

 

 

Which contraceptive methods have inherent failure rates?

 

a.

None

 

b.

Some

 

c.

All

 

d.

All except sterilization

 

Why do adolescents have the highest risk of developing pelvic inflammatory disease (PID)?

 

a.

They have the highest risk for bacterial vaginosis.

 

b.

They are the least at risk for developing other STIs.

 

c.

They are the most sexually active.

 

d.

They have decreased immunity to infectious organisms.

 

Exercise-induced amenorrhea is probably due to the combination of low body fat and decreased secretion of:

 

a.

Estrogen

 

b.

Prolactin

 

c.

Progesterone

 

d.

GnRH

 

What can result from an imbalance in the vaginal flora?

 

a.

Herpes simplex virus

 

b.

Human papillomavirus

 

c.

Chlamydia

 

d.

Bacterial vaginosis

 

The most effective means of obtaining the history of abuse is to use a communication model that:

 

a.

Avoids having the patient’s children present during the discussion

 

b.

Signals someone is interested and that the woman is not alone

 

c.

Emphasizes the belief that violence is not acceptable, no matter what the batterer might have said to the patient

 

d.

Allows the patient to talk without interruption and with time to relate, emphasize, and repeat her full story

 

What is the most common STI in the United States?

 

a.

Gonorrhea

 

b.

Chlamydia

 

c.

Syphilis

 

d.

Herpes simplex virus

 

 

Progestin-only pills (POPs):

 

a.

Have no possible side effects

 

b.

Suppress ovulation as reliably as COCs

 

c.

May be taken earlier or later than prescribed

 

d.

In combination with lactation are nearly 100% effective

 

 

According to the World Health Organization (WHO), the presence of a disease state:

 

a.

Necessitates prompt medical attention

 

b.

Excludes a person from being considered healthy

 

c.

Does not exclude a person from being considered healthy

 

d.

Classifies a person as in poor health

 

 

Which of the following might be a sign of hyperandrogenism?

 

a.

Irritable bowel syndrome

 

b.

Decreased sebum secretion in the skin

 

c.

Decreased muscle mass

 

d.

Acne associated with menstrual dysfunction

 

Surgical abortion represents an option for women who desire termination of pregnancy beyond:

 

a.

8 weeks’ gestation

 

b.

12 weeks’ gestation

 

c.

4 weeks’ gestation

 

d.

15 weeks’ gestation

 

How can weight loss specifically control symptoms of polycystic ovary syndrome (PCOS)?

 

a.

It decreases SHBG.

 

b.

It increases insulin resistance.

 

c.

It decreases androgen levels.

 

d.

It increases estrogen levels.

 

 

Why is acknowledging the oppression of women more difficult within Western societies?

 

a.

The multiplicity of minority groups complicates the issue.

 

b.

The availability of health care makes acknowledgment more difficult.

 

c.

The diversity of the news media clouds the issue.

 

d.

Affluence and increased opportunities mask oppression.

 

 

How does vaginosis differ from vaginitis?

 

a.

It must be treated with metronidazole.

 

b.

The discharge does not contain white blood cells.

 

c.

The discharge does not have an odor.

 

d.

It causes itching and/or burning.

 

 

What area of injury prevention is a focus of the USPSTF’s guidelines for counseling all healthy, asymptomatic women?

 

a.

Motor vehicle accidents

 

b.

Falls

 

c.

Domestic violence

 

d.

All of the above

 

 

What approach does Healthy People 2020 use to achieve its goals and objectives?

 

a.

Social determinants of health

 

b.

Evidence-based determinants of health

 

c.

Quality-of-life determinants of health

 

d.

Longevity promotion determinants of health

 

 

Approximately what percentage of women with bacterial vaginosis are asymptomatic?

 

a.

25%

 

b.

40%

 

c.

75%

 

d.

50%

 

The genetic counselor has a significant role in the care of women because BRCA1 and BRCA2 genetic mutations account for 5 to 10 percent of all _______ cancer cases.

 

a.

Breast

 

b.

Ovarian

 

c.

Uterine

 

d.

Pancreatic

Which organism causes 90% of vulvovaginal candidiasis episodes in women?

 

a.

Candida tropicalis

 

b.

Candida albicans

 

c.

Candida glabrata

 

d.

Candida krusei

 

What term refers to the period from about 7 to 10 days before menstrual flow begins until the first or second day of menstrual flow?

 

a.

Amenorrhea

 

b.

Premenstrual

 

c.

Dysmenorrhea

 

d.

Perimenstrual

 

The ParaGard IUD is impregnated with copper and is effective for:

 

a.

15 years

 

b.

3 years

 

c.

5 years

 

d.

10 years

 

What is the danger of giving estrogen replacement therapy (ERT) to menopausal women with an intact uterus?

 

a.

A higher risk of heart disease

 

b.

An increased likelihood of blood clots

 

c.

An increased likelihood of osteoporosis

 

d.

A higher risk of endometrial cancer

 

Although barrier contraception methods are less effective in preventing pregnancy than more modern methods, interest in them is on the rise because they:

 

a.

Can help protect against STIs, including HIV

 

b.

Are coitus dependent and require planning

 

c.

Are nonallergenic and male controlled

 

d.

Involve the use of hormones

 

A risk factor that could lead to endometrial cancer is:

 

a.

Early menopause

 

b.

Late menopause

 

c.

High blood pressure

 

d.

Cervical cancer

 

Of the two intrauterine contraceptive devices currently available in the United States only one provides a local delivery of protestin. It is the:

 

a.

Combined contraceptive patch (Ortho Evra)

 

b.

Copper IUD (T380A, ParaGard)

 

c.

LNG-IUS (Mirena)

 

d.

Dalkon Shield

 

Approximately what percentage of vulvar cancers occur in women older than the age of 50?

 

a.

50%

 

b.

70%

 

c.

85%

 

d.

60%

 

What is the best definition of abnormal uterine bleeding (AUB)?

 

a.

Uterine bleeding for which no pelvic pathology is found

 

b.

Uterine bleeding that is irregular during a woman’s menstrual cycle

 

c.

Uterine bleeding that is irregular in amount or frequency

 

d.

Uterine bleeding that is related to systemic conditions

 

The most common benign breast masses are:

 

a.

Galactoceles

 

b.

Hamartomas

 

c.

Fibroadenomas and cysts

 

d.

Lipomas and phyllodes tumors

 

Which cancer has the highest mortality rate of all gynecological cancers?

 

a.

Vulvar cancer

 

b.

Endometrial cancer

 

c.

Cervical cancer

 

d.

Ovarian cancer

 

Vulvovaginal candidiasis accounts for what percentage of all vaginal infections?

 

A.

10–15%

 

B.

20–25%

 

C.

50–55%

 

D.

60–65%

 

Which type of counseling results in a statistically significant reduction in STIs?

 

a.

Abstinence-only education

 

b.

Counseling delivered in multiple individual or group sessions totaling more than 3 hours

 

c.

Remote counseling via Internet or phone

 

d.

Brief, individual sessions in the primary care setting

 

Which of the following is an ethical issue that is specifically associated with pre-implantation testing with ART?

 

a.

Ownership of frozen embryos after the couple has divorced

 

b.

A surrogate deciding she does not want to relinquish the infant

 

c.

Genetic engineering and the ability to reject embryos affected by inherited disorders

 

d.

The implantation of multiple embryos, which can create high risk for the embryos and the woman

 

What symptom is present in 80 to 90 percent of women with cervical cancer?

 

a.

Abnormal vaginal bleeding

 

b.

Abnormal vaginal discharge

 

c.

Pelvic pain

 

d.

Ectopic pregnancy

 

If a patient has not reported a sexual assault to law enforcement, all of the following clinician actions are important except:

 

a.

Asking if reporting is something she wants to consider

 

b.

Discussing any fears or concerns that she may have about reporting

 

c.

Explaining that only some forced sexual contacts are reportable crimes

 

d.

Telling her that women who report do better psychologically than those who do not

 

What test should be ordered for a woman who is experiencing abnormal uterine bleeding (AUB) as well as headaches and peripheral vision changes?

 

a.

Thyroid-stimulating hormone test

 

b.

Nucleic acid amplification test

 

c.

Complete blood count

 

d.

Prolactin level test

 

What had been a significant problem in medical research well into the 1990s?

 

a.

The focus on randomized clinical trials over epidemiological investigations

 

b.

The lack of representation of women in research trials

 

c.

The lack of research related to gynecology

 

d.

The focus on randomized clinical trials over observational research

 

What is the definitive diagnostic technique for vulvar dermatoses?

 

a.

Pap test

 

b.

Biopsy

 

c.

Colposcopy

 

d.

Physical exam

 

Where in the breast do most malignancies develop?

 

a.

Upper inner quadrant

 

b.

Upper outer quadrant

 

c.

Lower outer quadrant

 

d.

Lower inner quadrant

 

Approximately how many Americans will contract one or more sexually transmitted infections during their lifetime?

 

a.

50%

 

b.

25%

 

c.

40%

 

d.

60%

 

In the GTPAL system for recording pregnancy history, the “T” stands for:

 

a.

Term births

 

b.

Terminal pregnancies

 

c.

Total number of pregnancies

 

d.

Type of birth (spontaneous, assisted, or cesarean)

 

Both very young and elderly sexual assault victims:

 

a.

Are addressed in most state mandatory reporting laws

 

b.

never has any difficulty describing the incident and related symptoms

 

c.

Require the same equipment for proper examination that others do

 

d.

Have fewer injuries than victims of other age groups

 

What is one of the side effects of hormonal contraceptives?

 

a.

Reduction in ovarian cancer risk

 

b.

Increased menstrual blood loss

 

c.

Increased risk of endometrial cancer

 

d.

Heavier menstrual flow

 

Tubal sterilization for women who have completed their families is highly effective, but there are disadvantages such as:

 

a.

Women are less likely to use condoms or return for health services.

 

b.

There is a decreased risk of ovarian cancer and pelvic inflammatory disease.

 

c.

There is a high likelihood of complications and side effects.

 

d.

The surgery is not covered by insurance.

 

What is the current (2006) recommendation by the CDC regarding HIV testing?

 

a.

Test all patients who report risk behaviors associated with HIV.

 

b.

Test all patients unless they explicitly decline to be tested.

 

c.

Test all patients.

 

d.

Test only those patients who ask to be tested.

 

What is generally the cause of Bartholin’s cyst?

 

a.

Complications from gonorrhea

 

b.

Cystic fluid in Bartholin’s gland becomes infected

 

c.

A fungal infection in Bartholin’s gland

 

d.

Obstruction of a duct in Bartholin’s gland

 

Which of the following factors associated with increased risk for developing osteoporosis appears to be the best predictor of risk?

 

a.

Smoking

 

b.

Low body weight

 

c.

Sedentary lifestyle

 

d.

Family history

 

What is the definition of primary amenorrhea?

 

a.

The cessation of menses for an interval of 6 months

 

b.

The failure to begin menses by age 14

 

c.

The cessation of menses due to outflow tract obstruction

 

d.

The failure to begin menses by age 16

 

In respect to an evidentiary examination:

 

a.

The patient may not withhold consent if the clinician is a mandated reporter.

 

b.

The clinician is required to strictly follow local agency protocols, no others.

 

c.

The time frame within which it must take place depends on local standards.

 

d.

Maintaining the chain of custody of all evidence collected is recommended, not required.

QUESTION 1

Which of the following is a diagnostic label that is listed in the Diagnostic and Statistical Manual IV-TR?

a.

Premenstrual dysphoric disorder

b.

Premenstrual magnification

c.

Dysmenorrhea

d.

Premenstrual syndrome

About half of all pregnancies in the United States are unintended and occur most frequently in women who:

a.

Are married or divorced

b.

Have finished high school

c.

Are between the ages of 18 and 24

d.

Are members of the majority group

 

 

 

 

What is one factor that can reduce the risk for the development of ovarian cancer?

 

a.

Multiple pregnancies

 

b.

Transvaginal ultrasounds

 

c.

Identification of recurrence

 

d.

Weight loss

 

 

What percentage of toxic shock syndrome cases are related to menses?

 

a.

50%

 

b.

25%

 

c.

75%

 

d.

90%

Tubal sterilization for women who have completed their families is highly effective, but there are disadvantages such as:

 

a.

Women are less likely to use condoms or return for health services.

 

b.

There is a decreased risk of ovarian cancer and pelvic inflammatory disease.

 

c.

There is a high likelihood of complications and side effects.

 

d.

The surgery is not covered by insurance.

 

Women who report experiencing the most severe symptoms of PMS tend to be: In their late 40s

a.

In their late 40s

b.

In their early 20s

c.

In their late teens

d.

In their late 30s

What is the definition of primary amenorrhea?

 

a.

The cessation of menses for an interval of 6 months

 

b.

The failure to begin menses by age 14

 

c.

The cessation of menses due to outflow tract obstruction

 

d.

The failure to begin menses by age 16

How many stages does the Tanner scale use to stage sexual maturity?

 

a.

3 stages

 

b.

5 stages

 

c.

6 stages

 

d.

8 stages

 

Which contraceptive methods have inherent failure rates?

a.

None

b.

Some

c.

All

d.

All except sterilization

What is the most common type of menstrual dysfunction related to hyperandrogenism?

 

a.

Painful menstruation

 

b.

Absence of menses

 

c.

Irregular bleeding

 

d.

Early menopause

 

Combined oral contraceptives (COCs) are among the most extensively studied medications available. Which one of the following statements about their use has been found to be true?

 

a.

Broad-spectrum antibiotics may enhance their efficacy.

 

b.

They do not increase the risk of venous thromboembolism.

 

c.

They decrease the relative risk of ovarian and endometrial cancers.

 

d.

Among possible side effects are acne, hirsuitism, and benign breast conditions.

 

Many patients experiencing intimate partner violence (IPV) meet the criteria for diagnosing PTSD. Those criteria include all of the following except:

a.

Experiencing a traumatic event

b.

Reexperiencing the traumatic event

c.

Numbness and avoidance

d.

Hypovigilance

Which of the following is an ethical issue that is specifically associated with pre-implantation testing with ART?

a.

Ownership of frozen embryos after the couple has divorced

b.

A surrogate deciding she does not want to relinquish the infant

c.

Genetic engineering and the ability to reject embryos affected by inherited disorders

d.

The implantation of multiple embryos, which can create high risk for the embryos and the woman

The ________ is probably the most widely used intimate partner violence (IPV) screen.

 

a.

Three-question AAS (McFarlane et al., 1992)

 

b.

Campbell’s Danger Assessment (2003)

 

c.

Sheridan’s HARASS Instrument

 

d.

Helton’s nine-question AAS

 

What is the term for the absence of menses for 3 to 6 months in a woman who has previously menstruated and is not pregnant, breastfeeding, or menopausal?

a.

Primary amenorrhea

b.

Initial dysmenorrhea

c.

Secondary amenorrhea

d.

Primary dysmenorrhea

Among women age 55 years and older:

 

a.

Macromastia is the most common cause of breast masses.

 

b.

Breast masses are presumed malignant until proven otherwise.

 

c.

Most breast masses decrease in size over time and many resolve completely.

 

d.

Diagnostic imaging of a breast mass and tissue sampling should be deferred.

 

Both very young and elderly sexual assault victims:

a.

Are addressed in most state mandatory reporting laws

b.

never has any difficulty describing the incident and related symptoms

c.

Require the same equipment for proper examination that others do

d.

Have fewer injuries than victims of other age groups

What is the major source of normal vaginal secretions?

 

a.

Bartholin’s glands

 

b.

Apocrine glands

 

c.

Sebaceous glands

 

d.

Cervical mucosa

 

Which one of the following statements about intimate partner violence (IPV) is false?

a.

It refers to an escalating pattern of abuse.

b.

It includes emotional abuse, such as disregarding what a woman wants.

c.

It includes using physical force to make a woman engage in a sexual act against her will.

d.

It refers to a current or former spouse or dating partner of the opposite sex, not someone of the same sex.

How is being overweight defined on the BMI table?

 

a.

18–29.9

 

b.

20–29.9

 

c.

25–29.9

 

d.

30 or greater

 

What has contributed to the decreased incidence of hepatitis B over the past 20 years?

a.

The decrease in PID

b.

The HBV vaccination

c.

The increase in condom use

d.

More precise screening methods

 

Which are the most common forms of hepatitis seen in women’s health practices?

 

a.

A and B

 

b.

A and D

 

c.

B, C, and D

 

d.

B and C

The factors that enable women to enjoy and control their sexual and reproductive lives, including a physical and emotional state of well-being and the quality of sexual and other close relationships, make up a woman’s:

a.

Sexual health

b.

Gender identity

c.

Gender role behaviors

d.

Psychosocial orientation

What test should be ordered for a woman who is experiencing abnormal uterine bleeding (AUB) as well as headaches and peripheral vision changes?

 

a.

Thyroid-stimulating hormone test

 

b.

Nucleic acid amplification test

 

c.

Complete blood count

 

d.

Prolactin level test

 

Surgical abortion represents an option for women who desire termination of pregnancy beyond:

a.

8 weeks’ gestation

b.

12 weeks’ gestation

c.

4 weeks’ gestation

d.

15 weeks’ gestation

What population of women should be screened for signs and symptoms of thyroid dysfunction?

a.

All women

b.

Older women

c.

Older women, smokers, and women with diabetes

d.

Older women, postpartum women, and women with Down syndrome

 

All of the following diagnostic testing and procedures are now infrequently performed in clinical practice except:

a.

Hysterosalpingogram

b.

Sperm penetration assay

c.

The postcoital test (PCT)

d.

Endometrial biopsy (EMB)

 

The most common site for endometrial implants found in other parts of the body is:

a.

The appendix

b.

The uterus

c.

The ovaries

d.

The fallopian tubes

Women who have had toxic shock syndrome should be instructed not to use tampons or:

 

a.

Barrier contraception methods

 

b.

Hormonal contraception methods

 

c.

Intravaginal antibiotic cream

 

d.

Oral antibiotics

Cyclic mastalgia:

 

a.

More likely causes unilateral, localized pain that is sharp or burning in nature

 

b.

Has an increased risk of occurrence in women whose diets are low in fat

 

c.

Occurs most frequently in women who are 18 to 30 years old

 

d.

Is caused by hormonal changes associated with menstruation

The incidence of uterine fibroids:

a.

Increases with age

b.

Decreases with age

c.

Is often caused by early menopause

d.

Is related to the age of first menses

Patients presenting for STI treatment should be screened for HIV:

 

a.

At each visit

 

b.

At the end of treatment

 

c.

At the beginning of treatment

 

d.

Each year

What screening recommendation is similar across all groups for colorectal cancer?

a.

Screening women age 76 to 85 based on risk factors

b.

Screening only for those women at increased risk

c.

Screening for all women starting at age 50

d.

Against routine screening in adults age 76 and over

 

Approximately what percentage of vulvar cancers occur in women older than the age of 50?

 

a.

50%

 

b.

70%

 

c.

85%

 

d.

60%

 

Signs of endometrial or cervical cancer may present abnormal uterine bleeding, often as heavy, prolonged bleeding or:

a.

Menometrorrhagia

b.

Amenorrhea

c.

Oligomenorrhea

d.

Polymenorrhea

 

In the GTPAL system for recording pregnancy history, the “T” stands for:

 

a.

Term births

 

b.

Terminal pregnancies

 

c.

Total number of pregnancies

 

d.

Type of birth (spontaneous, assisted, or cesarean)

What is now thought to be the most important causative agent in cervical cancer?

 

a.

PCOS

 

b.

Vulvar cancer

 

c.

Herpes simplex

 

d.

HPV

 

The most common sites of metastatic spread of invasive breast cancer include all of the following except:

a.

Bones

b.

Lungs

c.

Pituitary

d.

Lymph nodes

Who should be screened regularly for STIs?

 

a.

Women who have more than one sexual partner

 

b.

Women over the age of 21

 

c.

Women who are sexually active

 

d.

Women over the age of 15

 

What is a common vasomotor symptom of menopause?

a.

Blood clots

b.

Night sweats

c.

Osteoporosis

d.

Hysterectomy

 

What is the best definition of abnormal uterine bleeding (AUB)?

 

a.

Uterine bleeding for which no pelvic pathology is found

 

b.

Uterine bleeding that is irregular during a woman’s menstrual cycle

 

c.

Uterine bleeding that is irregular in amount or frequency

 

d.

Uterine bleeding that is related to systemic conditions

What should be the clinician’s first objective after learning the chief reason the woman desires care?

 

a.

To give the reason or problem a structural and chronological framework

 

b.

To probe for any additional concerns missed

 

c.

To take a family history related to the presenting concern

 

d.

To gain insight into the woman’s cultural and social influences

No risk factors other than age are identifiable in ______ of women with breast cancer.

 

a.

100%

 

b.

85%

 

c.

60%

 

d.

24%

The highest prevalence of human papillomavirus (HPV) is found among women ages:

 

a.

18–20

 

b.

20–24

 

c.

25–30

 

d.

30–35

Although barrier contraception methods are less effective in preventing pregnancy than more modern methods, interest in them is on the rise because they:

 

a.

Can help protect against STIs, including HIV

 

b.

Are coitus dependent and require planning

 

c.

Are nonallergenic and male controlled

 

d.

Involve the use of hormones

What has changed in terms of recommended antibiotic treatment for uncomplicated lower UTIs?

a.

Seven-day regimens are now recommended.

b.

Three times a day of oral antibiotics are now recommended.

c.

Three-day regimens are now recommended.

d.

A single dose is now recommended.

What is considered to be a common trigger of psoriasis?

a.

Stress

b.

Pregnancy

c.

Migraines

d.

Menstruation

The clinician is seeing a 48-year-old woman for the first time. She is overweight and has a blood pressure of 120/92. She is on no medications and does not smoke or drink alcohol. Her family history is negative for heart disease. Her physical exam is unremarkable. The clinician should advise her as follows:

 

a.

Her blood pressure is high normal and does not require further follow-up at this time.

 

b.

She has prehypertension.

 

c.

She has stage 1 hypertension.

 

d.

She needs two additional blood pressure checks on two separate occasions.

What tends to cause acne in adolescence?

a.

A decrease in estrogen

b.

Dietary changes

c.

Hormonal birth control use

d.

An increase in testosterone

The onset of labor is indicated by regular uterine contractions and:

 

a.

Complete dilation of the cervix

 

b.

Change in the position of the fetus

 

c.

Rupture of the membranes

 

d.

Progressive cervical change

The onset of labor is indicated by regular uterine contractions and:

 

a.

Complete dilation of the cervix

 

b.

Change in the position of the fetus

 

c.

Rupture of the membranes

 

d.

Progressive cervical change

Which of the following statements does not support the diagnosis of Alzheimer’s disease?

 

a.

Crying every day

 

b.

Forgetting where she puts things

 

c.

Getting lost driving to the grocery store

 

d.

Lost ability to balance a checkbook

 

A 23-year-old woman is seeing the clinician because of chronic headaches. These headaches are typically preceded by seeing flashing lights. These visual distortions spontaneously resolve followed by throbbing pain on either the right or left side of her head. Pain is associated with photophobia, nausea, and vomiting. The most likely diagnosis is:

a.

Cluster headache

b.

Migraine headache

c.

Temporal arteritis

d.

Transient ischemic attacks (TIAs)

 

When is round ligament pain most likely to occur in pregnant women?

a.

Between 6–8 weeks’ gestation

b.

Between 24–28 weeks’ gestation

c.

Between 10–12 weeks’ gestation

d.

Between 16–20 weeks’ gestation

Postpartum depression occurs in about what percentage of women who give birth?

 

a.

5–10%

 

b.

25–30%

 

c.

10–15%

 

d.

1–5%

 

 

About how many breastfeeding women are affected by lactation mastitis?

 

a.

10%

 

 

b.

20%

 

c.

15%

 

d.

25%

 

 

What is the most typical schedule of prenatal care in the first 28 weeks of pregnancy?

a.

Visits scheduled every 2 weeks

b.

Visits scheduled every 3 weeks

c.

Visits scheduled every week

d.

Visits scheduled every 4 weeks

 

 

About what percentage of pregnant women develop gestational hypertension, preeclampsia, or pregnancy-induced hypertensive disorder?

 

a.

5–7%

 

b.

10–12%

 

c.

1–3%

 

d.

12–15

 

What is the term for a postpartum disorder in which bacteria ascend from the lower genital tract and infect the uterus?

a.

Postpartum amenorrhea

b.

Postpartum endometritis

c.

Postpartum staphylococcus

d.

Postpartum lochia

How does women’s anatomy make them more susceptible to UTIs?

 

a.

Asymptomatic UTIs do not resolve themselves without treatment.

 

b.

Women tend to get UTIs when they are pregnant.

 

c.

There is a longer distance between the urethra and anus.

 

d.

Their urethras are shorter.

A 60-year-old woman has a blood pressure of 144/86. This would be classified as:

 

a.

Normal blood pressure

 

b.

Prehypertensive

 

c.

Stage 1 hypertension (per course hero)

 

d.

Stage 2 hypertension

 

 

 

 

After how many weeks’ gestation is a pregnancy loss considered a fetal death or stillbirth?

 

a.

18 weeks

 

b.

30 weeks

 

c.

20 weeks

 

d.

24 weeks

 

What can be used as a space-filling device, replacing normal pressure on the vaginal walls when levator ani support is unreliable?

a.

Diaphragms

b.

Tampons

c.

Kegels

d.

Sacral nerve stimulators

All of the following symptoms are associated with chest pain and representative of coronary artery disease except:

 

a.

Diaphoresis

 

b.

Jaw pain

 

c.

Pain with inspiration

 

d.

Shortness of breath

Screening for hyperlipidemia is recommended to begin at what age for women with no risk factors

 

a.

35

 

 

b.

40

 

c.

45

 

d.

50

What is the potential danger of a fetus born through meconium-stained amniotic fluid?

 

a.

The infant will not be able to relax its anal sphincter.

 

b.

The infant can breathe meconium into the lungs.

 

c.

The infant can get meconium caught in the esophagus.

 

d.

The infant will be born with jaundice.

What does rosacea describe?

 

a.

Adult acne

 

b.

Nail fungus

 

c.

Swelling of the joints

 

d.

Pruritis

Any woman with a complicated cystitis or symptoms of upper tract disease needs a urine culture and:

 

a.

Sensitivity test

 

b.

Blood culture

 

c.

Urine dipstick

 

d.

Parenteral culture

What is the definition of a primary headache?

 

a.

A headache that occurs only before and during menstruation

 

b.

A headache is caused by a preexisting condition

 

c.

A headache that is not a symptom of, or caused by, another condition

 

d.

A headache that is characterized by muscle tension

What is the leading cause of first-trimester maternal death?

 

a.

Ectopic pregnancy

 

b.

Complications from prior gynecologic surgeries

 

c.

Abortion

 

d.

Complications from unresolved STIs

When considering a diagnosis of Alzheimer’s disease, the clinician should:

 

a.

Interview her with a family member or close friend

 

b.

Interview her separately (alone) then with a family member or close friend

 

c.

Obtain the history from a family member or close friend

 

d.

Rely on client observation without obtaining a history

What is the most common cause of death in women in the United States?

 

a.

Breast cancer

 

b.

Cardiovascular disease

 

c.

Cervical cancer

 

d.

Lung cancer

What percentage of pregnant women in developed countries have iron-deficiency anemia?

 

a.

20%

 

 

b.

10%

 

c.

15%

 

d.

5%

How does the third stage of labor end?

 

a.

With the birth of the baby

 

b.

With the delivery of the placenta

 

c.

With the clamping of the umbilical cord

 

d.

With the complete dilation of the cervix

What is a possible cause of abdominal pain during pregnancy?

 

a.

Round ligament pain

 

b.

Diabetes

 

c.

Anemia

 

d.

Cytomegalovirus

Type 2 diabetes includes insulin resistance and affects what percentage of those who have diabetes?

 

a.

75–80%

 

b.

65–70%

 

c.

55–60% ?????

 

d.

90–95%

The primary endocrine disorders affecting women are diabetes mellitus and:

 

a.

Psoriatic arthritis

 

b.

Thyroid conditions

 

c.

Melanoma

 

d.

Polydipsia

When can relief from pregnancy induces nausea and vomiting be expected?

a.

6–8 weeks’ gestation

b.

12–14 weeks’ gestation

c.

20–22 weeks’ gestation

d.

 after 24 weeks’ gestation

What is the term for the craving and purposeful consumption of nonfood items for more than one month?

 

a.

Anemia

 

b.

Toxemia

 

c.

Pica

 

d.

Torsion

What significantly increases the risk of hypertension in women?

 

a.

The onset of menopause

 

b.

Hormonal replacement therapy

 

c.

Depression

 

d.

Atherosclerosis

Carbohydrate intolerance and increased insulin resistance first recognized in pregnancy is known as:

 

a.

Overt diabetes

 

b.

Gestational diabetes

 

c.

Carbohydrate overload

 

d.

Iron-deficiency anemia

A chronic skin disorder that is thought to be caused by an abnormal immune reaction in the skin is atopic dermatitis or:

 

a.

Rosacea

 

b.

Psoriasis

 

c.

Cellulitis

 

d.

Eczema

What is a potential benefit of circumcision?

 

a.

Decreased incidence of urinary tract infections

 

b.

Prevention of prostate cancer

 

c.

Increased immunity against herpes simplex virus

 

d.

Prevention of transmission of sexually transmitted bacteria

Without treatment shortly after birth, as many as 90 percent of infants born to hepatitis B–infected mothers will:

 

a.

Develop HIV

 

b.

Have cognitive difficulties

 

c.

Need blood transfusions

 

d.

Become infected

Fever associated with pyelonephritis will usually resolve within how many hours of treatment with antibiotics?

a.

24 hours

b.

12 hours

c.

72 hours

d.

80 hours

 

What is more likely to occur in women with female genital cutting?

a.

Low birth-weight babies

b.

Birth-related complications

c.

Miscarriages

d.

Premature births

What is the general goal of surgical treatment for stress UI?

 

a.

To increase the capacity of the bladder

 

b.

To increase pressure on the vaginal walls

 

c.

To support and strengthen the levator ani

 

d.

To support and stabilize the urethra

 

 

The clinician is ordering a lipid panel for a 50-year-old woman. The following advice should be given:

a.

Eat a normal breakfast the morning of the blood draw

b.

Fast for 12 hours prior to the blood draw

c.

No dietary changes

d.

Eat a low-fat breakfast the morning of the blood draw

All except which of the following are important historical questions for a 29-year-old woman in clinic for right-sided weakness?

 

a.

Use of oral combined hormonal contraceptives

 

b.

Recent childbirth

 

c.

History of recent deep venous thrombosis

 

d.

History of pelvic inflammatory disease

 

 

What is the initial symptom of Lyme disease, seen in approximately 70 to 80 percent of people infected with the bacterium?

a.

Red facial patches

b.

A circular red rash

c.

Rough bumps on the skin

d.

Shortness of breath

According to the CDC, what percentage of pregnant women continues to drink alcohol during their pregnancies?

a.

10%

b.

20%

c.

25%

d.

30%

What is a contributor to the increased incidence of heartburn during pregnancy?

 

a.

The increased incidence of hypertension during pregnancy

 

b.

The dilation of veins in the esophagus, due to increased blood flow

 

c.

The increased levels of magnesium and calcium in the blood

 

d.

The pregnancy hormone relaxin, which softens the lower esophageal sphincter

Gender differences in heart disease can be found in:

 

a.

Diagnosis

 

b.

Treatment

 

c.

Identification of symptoms

 

d.

All of the above

What is the recommended amount of Kegel contractions per day for women whose pelvic muscles are weak?

 

a.

10

 

b.

50

 

c.

30

 

d.

7

What is a common cause of leg cramps during pregnancy?

 

a.

An imbalance of calcium and magnesium

 

b.

Dehydration

 

c.

An inability to sleep

 

d.

Poor nutrition

 

 

 

 

 

 

 

What is the most common cause of medical complications in pregnancy?

 

a.

Hypertension

 

b.

Gestational diabetes

 

c.

Hepatitis

 

d.

Anemia

 

 

Which of the following is a predictor of impending preterm birth?

 

a.

Positive fetal fibronectin testing

 

b.

Cervical length less than 15 mm

 

c.

Meconium-stained amniotic fluid

 

d.

Cord prolapse

 

What is significant about cytomegalovirus (CMV)?

 

a.

It cannot be transmitted by person-to-person contact.

 

b.

It can remain dormant within the body for life.

 

c.

It is the most dangerous virus that can be transmitted to a fetus.

 

d.

It is experienced by about 25 percent of childbearing-age women before pregnancy.

 

 

A 30-year-old woman comes to clinic concerned about a headache that feels like a “rubber band squeezing her head,” which occurs nearly daily. It lasts several hours and is not associated with nausea or vomiting. She has no family history of migraine headaches. Her physical exam is within normal limits. The most likely diagnosis is

 

Tension Headaches

 

What is the percentage of all unintended pregnancies in the United States?

 

a.

5%

 

b.

15%

 

c.

25%

 

d.

50%

 

 

How often does breech presentation occur in singleton pregnancies?

 

a.

1–2%

 

b.

3–4%

 

c.

6–7%

 

d.

10–11%

 

 

How are pregnancy-related DHA (docosahexaenoic acid) needs best met?

 

a.

By consuming 2 servings of fatty low-mercury-content fish per week

 

b.

By taking a prenatal vitamin supplement

 

c.

By consuming 2 to 4 servings of fruit daily

 

d.

By consuming 3 to 4 servings of dairy products daily

 

 

What should be considered in order to interpret the Mini-Mental State exam when considering the diagnosis of Alzheimer’s disease? Education

 

a.

Education

 

b.

Family history of Alzheimer’s disease

 

c.

Medications that include estrogen

 

d.

Past history of concussion

 

 

About how many infants born to mothers colonized with Group B streptococcus will become colonized as well?

 

a.

40%

 

b.

25%

 

c.

10%

 

d.

50%

 

What is an indication of the second stage of labor?

 

a.

Complete dilation of the cervix

 

b.

Rupture of the membranes

 

c.

Emergence of the infant’s head

 

d.

Presence of bloody show

 

Approximately how many reproductive-age women in the United States meet the BMI criteria for obesity?

 

a.

1 in 5

 

b.

1 in 10

 

c.

1 in 4

 

d.

1 in 7

 

What should be addressed during late postpartum maternal evaluation (weeks 2–6)?

 

a.

The healing of the mother

 

b.

The need for birth control information or supplies

 

c.

The birth plan of the mother

 

d.

The latching-on response of the infant

 

What is important to consider when vaginal bleeding occurs during the first trimester?

 

a.

Uterine size

 

b.

Ectopic pregnancy

 

c.

Viral infection

 

d.

HIV

 

 

 

 

Optimal weight gain during pregnancy is based on the woman’s prepregnant BMI and:

 

a.

Age

 

b.

Height

 

c.

Nutritional assessment

 

d.

Caloric intake

 

 

What is the most common disorder leading to hyperthyroidism?

 

a.

Parkinson’s disease

 

b.

Graves’ disease

 

c.

Multiple sclerosis

 

d.

Epilepsy

 

A 72-year-old woman is presenting with chest pain. Which of the following statements best differentiates chest pain due to angina versus myocardial infarction?

 

a.

Angina pain is frequently relieved by nitroglycerin.

 

b.

Angina pain is more substernal and does not radiate to other areas.

 

c.

Myocardial pain with an infarction is always associated with fatigue.

 

d.

Myocardial pain with an infarction is more severe.

 

At what time during pregnancy does nausea typically occur?

 

a.

At 3–6 weeks’ gestation

 

b.

At 6–8 weeks’ gestation

 

c.

At 12–15 weeks’ gestation

 

d.

At 1–3 weeks’ gestation

 

 

What step can a clinician take to learn more about any chemicals used in a woman’s workplace?

 

a.

Contact OSHA (Occupational Health and Safety Administration).

 

b.

Contact the woman’s workplace.

 

c.

Ask the woman to obtain her workplace MSDs (material safety data sheets).

 

d.

Conduct research on the OSHA website.

 

Where does edema tend to occur in the pregnant woman’s body?

 

a.

Hands

 

b.

Face

 

c.

Feet

 

d.

Abdomen

 

What is the term for stimulation of the uterus by an external agent to enhance uterine contractions after labor has started?

 

a.

Exteriorization

 

b.

Induction

 

c.

Augmentation

 

d.

Presentation

 

 

Uncomplicated acute bacterial cystitis occurs in women who:

 

a.

Are pregnant

 

b.

Have no signs of upper tract infection

 

c.

Have a high fever

 

d.

Have had recent antibiotics

 

 

Chest pain associated with irritation of the myocardial nerve fibers (such as with angina pectoris or myocardial infarction) is due to an increase in:

 

a.

Blood glucose

 

b.

Lactic acid

 

c.

Serum magnesium

 

d.

Serum potassium

 

What was the reason that prenatal care began in the early 1900s?

 

a.

To screen for preeclampsia

 

b.

To predict preterm births

 

c.

To assess women’s nutritional needs

 

d.

To test women for disease

 

A common prenatal care model in which women have their first visit with one provider and then subsequent visits in a group setting is called:

 

a.

HolisticBirthing

 

b.

Midwifery

 

c.

CenteringPregnancy

 

d.

PathologyCare

 

Which of the following symptoms are suggestive of a cluster headache?

 

a.

Bilateral, aching pain not associated with nausea or vomiting and not aggravated by physical activity

 

b.

Pain in the left temporal area behind the left eye associated with fever and jaw claudication

 

c.

Pulsating pain on the left side of the head associated with nausea, vomiting, and photophobia

 

d.

Thirty-minute episodes of right-sided pain occurring 3–5 times daily associated with rhinorrhea and conjunctival injection

My PICO RESEARCH QUESTION
:
 Is topical fluoride as effective in managing and reducing dentinal hypersensitivity, in comparison to the application of fluoride iontophoresis?

> 1. You must research 
3 articles
  that pertain to topic .

> 2. MUST FOLLOW THE PICO FORMATTING!

> 3. For 
each article
, you must follow the 
attached outline
. Attached is a sample of the outline to be followed for the assignment. 
It should be followed exactly as shown
, however it should pertain to my topic. You must reference ALL work throughout the paper and at the end of the assignment.

4. Each article 
must contain/discuss:
 the
 title, the purpose, methods, results, critique and conclusion
 (please do not go off topic, the goal it to answer the PICO question designed by the end of the assignment)

Dental Hygiene

This paper is an analytical essay that examines the issue of whether topical fluoride can be effective in the management and reduction of tooth hypersensitivity. The essay shall compare whether using this topical fluoride is more effective when compared to the application of fluoride

iontophoresis. The PICO format shall be employed in analyzing three research papers related to this topic.

a) Article One.

Title

Botzenhart, U.,Braun, A., & Frentzen, M. (2012). Laser treatment of dentine hypersensitivity : An overview Part I

ii) Purpose

The authors of this paper carried out this study to investigate and compare the efficiency in using topical fluoride and laser techniques in the treatment of tooth sensitivity (Botzenhart et al, 2012). This article illustrates the benefits of using fluoride treatment through topical application and how this technique is more superior and effective compared to low laser radiation. At the same time, these two techniques are compared for efficacy when it comes to the management and treatment of tooth hypersensitivity (Botzenhart et al, 2012).

iii) Methods

This research study employed the use of comparison where conventional methods were compared against the use of laser technology. The effects of these two techniques were rated in terms of how they managed and reduced teeth hypersensitivity.  The research article mainly employed the methodological angle of review from research already done (Botzenhart et al, 2012). Hence, it provided secondary data with regards to sampled participants who had been previously treated with a diode laser that had a low energy level on each side. These diodes were meant to monitor the hypersensitivity level of teeth after the respective individual underwent the process of root canal, root planning and scaling.

The methodology also showed how control groups were used and administered with a different form of treatment which included  topical fluoride application. The latter contained a combination of protective varnish and fluoride that was meant to desensitize the teeth. All these sampled participants or patients were given a baseline encounter after which the pain and hypersensitivity of teeth were measured on a two-day interval. This pain was rated as either low, medium or high by each of the patients subjected to this study.

iv) Results

The findings of this study indicated that the occurrence of tooth hypersensitivity  was significantly reduced by a larger percentage. These results were achieved a few days after the treatment was administered to the patients. This is in contrast to the control group that was given topical fluoride for treatment of teeth hypersensitivity that did not report any decrease or changes after this medication was administered (Botzenhart et al, 2012). The complete absence of teeth hypersensitivity was only reported when the patients were given low laser treatment. In fact, the results showed that at least most of the patients who received diode laser treatment showed lesser hypersensitivity of teeth as compared to a dismal number of patients who were given topical fluoride treatment.

v) Critique

This research study settled for the use of a small sample size that is not representative of the entire human population that suffers from teeth hypersensitivity problems. Therefore, the findings could not be graphically drawn to indicate that the treatment regimen tested is conclusive based on the given sample size. A larger number of participants could have been sampled so as to make the study more representative and improve the validity of the findings.

vi) Conclusion

The authors of this paper concluded that the use of diode laser treatment of low energy is one of the successful ways of managing and treating tooth hypersensitivity (Pesevska et al, 2010).  This is in comparison to the use of topical fluoride that yields less success since it does not manage to completely eradicate tooth pain or issues of sensitivity.

b) Article Two

i) Title

Hashim, N. T., Gasmalla, B. G., Sabahelkheir, A. H., & Awooda, A. M. (2014). Effect of the clinical application of the diode laser (810 nm) in the treatment of dentine hypersensitivity. BMC Research Notes, 7(1), 1-9. doi:10.1186/1756-0500-7-31

ii) Purpose

Hashim et al (2014) carried out this study to evaluate and determine the effect of using diode lasers as one of the fluoride iontophoresis techniques in reducing tooth hypersensitivity. This technique was mainly applied so as to gauge the tensile strength of bonds between the coronal dentine and two additional adhesive systems. Additionally, the tubule occlusion was also measured quantitatively with regards to its role in minimizing the sensitivity of teeth.

iii) Methods

The researchers made use of twelve teeth that were obtained from willing individuals who were made known about the study (Hashim et al, 2014). These teeth were the third molars that were divided into four different groups.  The first group involved treatment with a total adhesive system only while the second group was treated with the same adhesive after undergoing treatment with fluoride iontophoresis (Hashim et al, 2014). The third group was treated with a different adhesive known as a self-etching system. Finally, the fourth group was treated with the same adhesive after fluoride iontophoresis was administered. These four groups were also fixed with a resin composite that was meant to produce additional beams to enhance their tensile strength.

iv) Results

The results of this experiment were obtained after each test was treated differently through fluoride iontophoresis. The four groups were passed through scanning electron microscopes or SEMs where the images were recorded and analyzed through a statistical software (Hashim et al, 2014). The results were analyzed through the use of analysis of variance or ANOVA, probability and significant difference tests. According to the results, there was a significant difference (P ≤0.002) among  the groups that were treated with fluoride iontophoresis (Hashim et al, 2014).  The other groups that did not undergo the latter process registered no significant difference (P=1.000) in terms of reducing the sensitivity of teeth.

v) Critique

This experimental research made use of different statistical tools that did not properly capture the effectiveness of using fluoride iontophoresis as a mode of treating hypersensitivity in the teeth (Hashim et al, 2014).  Moreover, the use of molar teeth extracted from patients could not be deemed as a viable way of determining the reduction of pain. The alternative approach of measuring tubule occlusion is so not very appropriate with regards to the management  this dental condition.

 

 

vi) Conclusion

This research study was able to conclude that the use of fluoride iontophoresis is an effective way of treating the occurrence of hypersensitivity in the teeth (Hashim et al, 2014). The significant increase in the tubule occlusion was used as the indicator of the level of effectiveness of this technique. Hence, dentists can recommend to their patients that the hypersensitivity in the teeth can be significantly reduced and managed through the implementation of fluoride iontophoresis.

c) Article Three

i) Title

Hosoki, M., Bando, E., Asaoka, K., Takeuchi, H., & Nishigawa, K. (2009). Assessment of allergic hypersensitivity to dental materials. Bio-Medical Materials & Engineering, 19(1), 53-61. doi:10.3233/BME-2009-056

ii) Purpose

This research was conducted through a long-term study that sought to compare the efficiency in the treatment for both topical fluoride use and fluoride iontophoresis by considering whether patients had any form of allergies towards various dental materials. The study aimed at investigating how serious the cases of dental hypersensitivity can be and what would be the most appropriate form of treatment (Hosoki et al, 2009).

iii) Method

The study employed the use of  a total of 212 patients (n=212) who were subjected to different forms of treatment (Hosoki et al, 2009). The patients were divided into male and female groups where 45 males and 167 females took part in the study. The sampled participants were then subjected to thirteen different forms of treatment with each of them testing for the extent of dental hypersensitivity (Hosoki et al, 2009). The extent and level of teeth allergic reactions were then recorded and tabulated accordingly.

iv) Results

The results of this study showed that the effectiveness of the topical application of fluoride in treating tooth hypersensitivity was directly related to the extent of teeth damage as well as the composition of the allergens used in the research process. In addition, if the treatment administered was closely related to the allergen the patient suffered from, then patients who suffered from severe or acute teeth hypersensitivity had the pain reduced significantly through the use of appropriate fluoride treatments.

v) Critique

The duration of this research study was too long such that the patients and sampled individuals would have easily grown tired or weary. Additionally, the financial implications of this study were too high considering the extended time frame employed in the process of comparing the efficacy of these two techniques.

vi) Conclusion

This research was able to illustrate that fluoride iontophoresis is very effective when it comes to the management and reduction of issues of hypersensitivity in the teeth (Hosoki et al, 2009).  However, the process can be quite costly due to the technical aspects involved. On the other hand, the use of topical application of fluoride is less effective but affordable altogether. Therefore, fluoride iontophoresis should be the recommended regimen for minimizing teeth hypersensitivity for people facing a recurrent problem in their dental area.

 

 

References

Botzenhart, U., Braun, A., & Frentzen, M. (2012). Laser treatment of dentine hypersensitivity:     An overview Part I

Hashim, N. T., Gasmalla, B. G., Sabahelkheir, A. H., & Awooda, A. M. (2014). Effect of the       clinical application of the diode laser (810 nm) in the treatment of dentine         hypersensitivity. BMC Research Notes, 7(1), 1-9. doi:10.1186/1756-0500-7-31

Hosoki, M., Bando, E., Asaoka, K., Takeuchi, H., & Nishigawa, K. (2009). Assessment of            allergic hypersensitivity to dental materials. Bio-Medical Materials & Engineering, 19(1),   53-61. doi:10.3233/BME-2009-056

Principles of Toxicology

 

Name:

Tutor:

Course:

Number:

Date:

 

 

 

 

 

 

Principles of Toxicology

Conflicts in Risk Assessment: Analysis of medical agents used in health promotion and treatment.

Question of focus for the essay: Is the use of medical agnts safe enough to prolong life or it also disrupts major biological and physiological processes and functions?

The emergence and  discovery of modern methods and modes of treatment has been very instrumental towards the prolonging of life of most people. This directly contrasts the ancient times when people were very apt and prone to contracting illnesses due to the unsanitary techniques used in treatment (Chau et al, 2014). The modern era has witnessed a wave of revolution in health care such that an ocean of medication can now be used to remedy the same illness. However, the ethical concerns and efficacy of most medicines remains questionable owing to their adverse drug reactions in the body (Rice et al, 2015).

Principles of toxicology dictate that agents used to treat infections, illnesses or diseases should have minimal effect on the human host and maximum effect on the causative agent of the disease (Pavey et al, 2015). There are many queries and concerns that have been raised when certain chemicals are introduced as remedies into a health issue. For instance, fluorine is commonly used to treat water and eliminate pathogenic microflora that may easily establish infections in the human body (Kadiyala and Tan, 2013). However, the same fluorine is also dangerous since if used in excess, it can lead to teeth discoloration or bring about hormonal imbalance in the body.

These side effects can be dangerous to a person who suffers from a hormonal disorder such as poor serotonin absorption. Another example is where the use of hydrocortisone is prescribed as an anti-inflammatory drug (Zhang et al, 2014). However, the same chemical is known to damage the melanin pigment of the skin that is very important in protecting the body from harmful radiation. Therefore, an equilibrium point should be established and agreed at what level is it safe to use certain chemicals so that toxicological effects are minimized.

Policies and Regulations That Can Help in Revising the Principles of Toxicology

The best and most suitable approach that can be recommended in this case is the introduction of a policy or act of  law that would govern the use of toxic agents and chemicals. For instance, an Act of Law would define the chemical or agent in question and then go ahead to outline its benefits to the human body (Zhang et al, 2014). Additionally, this act would also include the hazards or side effects of using this agent on a continued basis or in excess. At the same time, the policy would also oversee the use of controversial chemicals and dictate their application within various situations. This information can be communicated to the larger public through a gazette notice that would outline them in meticulous detail.

The introduction of a policy that strictly or solely deals with toxic agents would easily capture the attention of the public. If  a person is made away that cortisone as a chemical can inhibit or impair the melanin pigment, then they would become more concerned about it. This would mean gathering information on how this chemical works in the body and at what point it is bound to elicit an adverse drug reaction (Zhang et al, 2014). Additionally, the policy should be deliberated  within a public forum such that people are included in the official process of reducing toxicological effects of controversial chemical agents.

Conclusively, medicines and treatment agents have highly transformed human lives by prolonging it for a couple of years. However, some of them introduce toxic effects in the body and that is why policies and government acts should be implemented to mitigate such negative effects.

 

References

Chau, M. M., Kong, D. M., Hal, S. J., Urbancic, K., Trubiano, J. A., Cassumbhoy, M., & … Worth, L. J. (2014). Consensus guidelines for optimising antifungal drug delivery and monitoring to avoid toxicity and improve outcomes in patients with haematological malignancy, 2014. Internal Medicine Journal, 44(12b), 1364-1388. doi:10.1111/imj.12600

Kadiyala, I., & Tan, E. (2013). Formulation approaches in mitigating toxicity of orally administrated drugs. Pharmaceutical Development & Technology, 18(2), 305-312. doi:10.3109/10837450.2012.734516

Pavey, R. A., Kambil, S. M., & Bhat, R. M. (2015). Dermatological adverse reactions to cancer chemotherapy. Indian Journal Of Dermatology, Venereology & Leprology, 81(4), 433. doi:10.4103/0378-6323.15995

Rice, H., Dalton, C. H., Price, M. E., Graham, S. J., Green, A. C., Jenner, J., & … Timperley, C. M. (2015). Toxicity and medical countermeasure studies on the organophosphorus nerve agents VM and VX. Proceedings Of The Royal Society A: Mathematical, Physical & Engineering Sciences, 471(2176), 1-14. doi:10.1098/rspa.2014.0891

Zhang, J. D., Berntenis, N., Roth, A., & Ebeling, M. (2014). Data mining reveals a network of early-response genes as a consensus signature of drug-induced in vitro and in vivo toxicity. Pharmacogenomics Journal, 14(3), 208-216. doi:10.1038/tpj.2013.39

Topic

Name

Date

 

 

Bisphenol A also known as BPA has for a long time been a chemical with contradicting issues. BPA is a chemical that for many years has been used in the hardening of plastics. This chemical is found in almost everything, like some medical device, dental sealants, water bottles, water discs, the lining of canned food and drinks as well as many other products. According to studies over 90% of people use BPA in their bodies (Vaughn, 2010).  Most of it gets in the body while we eat foods that have been in containers that are made of BPA. It is possible to pick this chemical through dust, water and air.

This chemical is also common in Sippy cups, baby bottles, beauty formula cans and other products that are used in infants and young children. According to the report given by the health departments, children toys do not have BPA. On the same note the outer shield of some pacifiers have BPA. However, his chemical is not found on the nipple that the baby sucks. For a long time, people used BPA without thinking of the risks and the harm it can bring especially to children. According to studies, there are some concerns about the use of BPA. These products can affect the prostate glands in fetus and children, brain and the way a person behaves (Gibert, 2015).

On the other hand, there is the benefit that is brought by using BPA. For instance, BPA is used in the making of some critical components of the numerous medical device as well as their housings. BPA has an optical clarity that is used for direct observation of fluids in the body including the blood (Vogel, 2012). By observing the liquids, the health caregivers can be able to monitor the flow. The health care gives depended on the equipment as well as medical devices that have been made with BPA so that they can be able to have a transparent view of the body of a human (Hayes & Laudan, 2009). This view makes it easy for them to check for the presence of air bubbles or any other obstructions during the procedure.

Note that numerous different things that can be said about BPA, but in my opinion, this chemical should continue to be used due to the benefits that it brings. For instance without this chemical, there could have been many deaths that could rise from obstructions in the body fluids when a patient is undergoing medication (Rosenfeld & Feng, 2011).. Unless there is a100% prove of damages that this medicine brings, and then it should continue to be used. Science comes up with theories that are challenged every day. The theory behind BPA is one of such. They have not produced clear prove that shows the product is poisonous.

By burning BPA there are so many areas that will be affected, this chemical makes a broad range of things like receipt of the store sales, police shield, reading glasses, bullet prove glass, LED lights and many more. This is some of the things that are used on daily basis; some of them are even used to aid day to day living. This is the reason that cutting BPA out of the market will mean bringing a lot of things to a standstill. To avoid this, scientist, should continue with their study and come up with something that is concrete. A point that should be considered is that for a long time BPA has been used, even on infants and little or no harm came on their way.

In conclusion, there are so many chemicals that have the benefit on humans, and yet it also causes serious damage. BPA, if any at all causes low harm on humans and should not be banned.

 

 

 

References

Gibert, Y. (2015). 
Bisphenol A: Sources, risks of environmental exposure and human health

effects
. New York: Nova Publishers.

Hayes, D., & Laudan, R. (2009). 
Food and nutrition
. New York: Marshall Cavendish Reference.

Rosenfeld, P. E., & Feng, L. G. H. (2011). 
Risks of hazardous wastes
. Amsterdam:

Elsevier/William Andrew.

Vaughn, B. C. (2010). 
Bisphenol A and phthalates: Uses, health effects and environmental risks
.

New York: Nova Science Publishers.

Vogel, S. A. (2012). 
Is It Safe?: BPA and the Struggle to Define the Safety of Chemicals
.

Berkeley: University of California Press.

HYPERSENSITIVITY

 

 

 

 

 

Name:

Course:

Tutor:

College:

Date:

 

Hypersensitivity

The human immune system is often tasked with the physical obligation of protecting the body from foreign pathogens that may invade it. The instigation or onset of a hypersensitivity reaction is often as a result of an abnormal reaction of the immune system towards a foreign pathogen or antigen. Hypersensitivity is often used to describe allergies, which arise out of the body detecting the presence of a foreign object that the body is not used to normally. There are various methods of treatment and therapy that have been devised to tackle the diverse types of hypersensitivity reactions or conditions. This paper is a brief essay that compares two therapeutic measures for hypersensitivity and which one works best for research.

Therapeutic Measures for Hypersensitivity.

There many different methods that are employed in the treatment of hypersensitivity or allergic reactions. The mode of treatment that is chosen depends on the extent of the hypersensitivity as well as the causative agent (Legendre et al 2014, p. 145). The two therapeutic measures that can be adopted for both hypersensitivity and research purposes are immunotherapy and use of medication (Karnoub et al 2015, p. 2). The latter is the most common method that is used to treat hypersensitivity. However, the medicine that is administered to the patient depends on the nature of the allergic reaction they have (Jones et al 2015, p. 198). Both immunotherapy and medications can be evaluated as a treatment regimen for allergies based on the PICO approach.

PICO deals with the patient or population receiving the treatment, the intervention used, control and the resultant outcome. In this case, PICO can be used to ascertain if these two therapeutic methods are effective for the patient, the nature of their intervention, the control measures employed and whether there are any side effects from their usage (Medical Literature, 2015). The medication approach is often used for the control of hypersensitivity reactions which are mostly allergens. Antihistamines and decongestants are the most common medicines prescribed for patients with allergic symptoms (Stone et al 2014, p. 12). Decongestants are known to control allergies such as asthma or stuffy noses. Likewise, antihistamines and corticosteroids are also prescribed when a patient has a hypersensitivity inflammation. On the other hand, immunotherapy is a different form of hypersensitivity treatment that makes use of small doses of the allergen to which the patient is allergic to presently (Berroa et al 2014, p. 276).

Immunotherapy is mainly used to treat allergies such as pollen, dust, bee venom or even flower and coffee pheromones. The use of minimal or small doses of the allergen is meant to trigger the immune system into becoming less sensitive to this foreign substance (Legendre et al 2014, p. 145).   Consequently, the immunity of the person responds by hindering the release of antibodies, which means that allergic reactions with then be avoided. Immunotherapy is very effective in treating conditions such as rhinitis, anaphylaxis and other frequently occurring allergies. Both medication and immunotherapy are effective because they are able to minimize the production of antibodies within the immune system (Legendre et al 2014, p. 145).

Additionally, both of these therapeutic interventions are known to have very minimal side effects or adverse drug reactions that can at times be acute. Instead, they usually restore the health of the patient with little damage to the physiological functioning of the body (Medical Literature, 2015). The success of these forms of treatment lies in first establishing the factors that strongly trigger the hypersensitivity reactions. Blood tests as well as skin tests are known to give the main allergens that cause one to be hypersensitive. Hence, after this is diagnosed, it then becomes easier to decide whether to use medication or immunotherapy interventions.           Conclusively, both medication and immunotherapy are effective therapeutic measures for treating hypersensitivity and research into both modes of treatment has revealed their numerous advantages to the affected patient.

 

 

 

References

Berroa, F, Lafuente, A, Javaloyes, G, Ferrer, M, Moncada, R, Goikoetxea, M, Urbain, C, Sanz, M, & Gastaminza, G 2014, ‘The usefulness of plasma histamine and different tryptase cut-off points in the diagnosis of peranaesthetic hypersensitivity reactions’, Clinical & Experimental Allergy, 44, 2, pp. 270-277, Academic Search Premier, EBSCOhost, viewed 14 September 2015

Jones, J, Richter, L, Alonto, A, & Leedahl, D 2015, ‘Desensitization To Ceftaroline In a patient with multiple medication hypersensitivity reactions’, American Journal Of Health-System Pharmacy, 72, 3, pp. 198-202, Academic Search Premier, EBSCOhost, viewed 14 September 2015

Karnoub, M, Zairi, F, Aboukais, R, & Assaker, R 2015, ‘Delayed Hypersensitivity Reaction: An Increasingly Recognized Complication of Metal-on-Metal Total Disc Replacement’, Case Reports In Orthopedics, 2015, pp. 1-3, Academic Search Premier, EBSCOhost, viewed 14 September 2015

Legendre, D, Muzny, C, Marshall, G, & Swiatlo, E 2014, ‘Antibiotic Hypersensitivity Reactions and Approaches to Desensitization’,Clinical Infectious Diseases, 58, 8, pp. 140-148, Academic Search Premier, EBSCOhost, viewed 14 September 2015

Medical Literature. (2015).
PICO formula
. Retrieved on 14 Septermber 2015 from http://learntech.physiol.ox.ac.uk/cochrane_tutorial/cochlibd0e84.php

Stone, S, Phillips, E, Wiese, M, Heddle, R, & Brown, S 2014, ‘Immediate-type hypersensitivity drug reactions’, British Journal Of Clinical Pharmacology, 78, 1, pp. 1-13, Academic Search Premier, EBSCOhost, viewed 14 September 2015

TOPIC: Primary Care

Research Paper Assignment

 

Primary care has been touted as the answer to real transformational change

and improved integration of 
Ontario’s health care system
.

–    Discuss the definitions of primary (health) care and primary medical

    care and the similarities and differences between them.

–    Describe the rationale behind the belief that primary care is a critical component of improved integration.

–    Discuss the key roadblocks that must be addressed and what can/should be done

Evaluation Criteria

.Application of the concepts and frameworks from lectures and readings

.Ability to synthesize and incorporate course ideas

.Ability to construct a coherent and well-informed argument based on a review of the literature (new articles beyond the course readings are required).

.Clarity of the research paper

.Note that descriptive papers are not sufficient as the teaching team wants to see an understanding and not merely a regurgitation of information.

 

 

 

 

 

 

PRIMARY CARE

 

 

 

 

 

 

 

Name:

Course:

Tutor:

College:

Date:

 

Primary Care

The state of complete mental, physical and social well being of a person combined with the absence of disease and infirmity is what constitutes good human health. The health care sector is mandated with the task of overseeing that its citizens are able to remain in a state of complete physical health. There are different departments and sections within the health care department that serve these functions at a variable level. One of these departments is the primary care sector that forms the core foundation of most health care systems. Primary care is one of the sections within health care that serves the umbrella function of providing very basic care to patients. This care is often  provided on a daily basis by either a physician, health worker or a nurse. The person offering this kind of care is usually the first person of contact with the patient and they are supposed to coordinate all other involvements with this sick person. Due to the basic nature of primary health care, many countries and states have put in place measures to improve the service delivery.

In Ontario, primary care has been touted as the answer to real transformational change and improved integration of its health care system. This is because primary care is regarded as one of its fundamental pillars in the health system. Therefore, this state thrives to foster the improvement of quality medical and health care to its people. It does this by providing the appropriate and adequate resources, strategies and initiatives to help primary care to become more efficient. The primary care providers such as the nurse practitioners and the physicians are also given additional training so that they can be competent at what they do. In any case, the core aim of primary care is to make sure that patients receive the most basic treatment and care in a quality and effective manner. This paper is an incisive and descriptive essay that discusses the importance of primary care by focusing on Ontario’s health care system.

Discuss the definitions of primary (health) care and primary medical care

Primary health care or PHC is a segment of health care that deals with scientific and socially accepted methods of providing health care to individuals. This type of care is tasked with the duty of ensuring that health care is accessible to everyone within the community, society or even country (Chrystal et al, 2015). As such, primary health care strives to become universal, so that every person can at least have access to a medical facility. PHC is also an approach that strives to see that health is achieved through additional medical and social policies. This bracket of health care includes all the areas that play a very instrumental role in health (Phillips et al, 2014).

This means that primary health care is intertwined with the individual’s lifestyle, their environment and how they access health care. Consequently, primary health care can be considered as a cornerstone that can be used to achieve the ideal health system on a universal scale. The ultimate goal and objective of primary health care is to improve health accessibility and ensure that all people can be able to visit a health facility (Pype et al, 2014). PHC is able to do this by reducing the gap that exists between social classes and disparities in the health care sector. Secondly, PHC also strives to organize and deliver health services that are within the needs and expectations of the people. This is normally considered as part of service delivery reform. Thirdly, primary health care aims at integrating health into all the available sectors of the economy (Thomas et al, 2015).

This includes both the public and private policies of reforms. In addition, PHC also pursues the collaborative models of policy and dialogue so that it can increase the participation of the respective stakeholders (Thomas et al, 2015). On the other hand, primary medical care aims at providing the highest quality of medical care to all sick people and patients. In addition, primary medical care or PMC endeavors to prevent illnesses, diseases and health conditions in the patients themselves. The overall aim of PMC is to work together with the health professionals to provide quality care that is also comprehensive and integrated as well (Giltenane et al, 2015). The practice of PMC includes the promotion of health, prevention of diseases, maintaining health and diagnosis of diseases. In addition, primary medical care also deals with counseling and educating the patient, providing in-patient and out patient care as well as offering other medical forms of care such as home care and day care.

Primary medical care is performed and provided by a personal physician, doctor or health practitioner. This person works with the collaboration of other important parties such health professionals (Jenstad and Donnelly, 2015). This ensures that the provision of PMC is such that there is a total utilization of the appropriate processes so that medical care is of utmost quality. In addition, PMC strives to become cost-effective so that virtually all people can afford it. Primary medical care is a practice that is considered as the first point of entry of the patient to the health care system. What’s more, it also serves as a continuing focal point for the medical care services that are needed (Mundt et al, 2015).

This means that primary medical care also has a mission of providing patients with the access to the physician or doctor that they want to treat them.  In overall, primary medical care is generally structured to provide medical attention to the larger majority. The state of Ontario is striving hard to provide quality primary medical and health care. ­Presently, Ontario does not have a well coordinated or comprehensive approach  that deals with the performance of this medical sector. In fact, statistics show that Ontarios primary medical and health care compare quite poorly with other states and cities (Ngiap et al, 2014).

This means that the health care sector in Ontario also falters if it is compared to other states on the same level. As such, a lot of effort is being placed towards the primary care sector in Ontario so that areas and loopholes of possible improvement are identified. This began when the health quality unit in Ontario saw the dire need to have a large-scale approach that can measure the performance of both primary medical and health care (Ngiap et al, 2014).

This measurement can be done at the practice and system levels where specific programs are usually launched. These performance initiatives are undertaken together with the collaborative efforts of key stakeholders in the medical fraternity. The end product of these efforts is to ensure that health care is available and affordable for all.

Similarities and differences between primary (health) care and primary medical care

Both primary medical care and primary health care are perceived to be the most comprehensive rationale behind the provision of health and medical services. However, the two fields of care have a number of similarities and differences. Primary medical care and primary health care are two terms that are used interchangeably on a very regular basis. However, it should be noted that the two terms are used to denote and refer to very different concepts. These two terms describe very distinct and unique entities that relate to aspects within the medical field. Primary medical care deals with approaches that include policies and regulations that can reform the sector. One of the similarities between PMC and PHC is that both of these terms deal with the process of providing medical attention in the best way possible (Chrystal et al, 2015).

Both of these disciplines strive to ensure that medical attention is available to people at an affordable cost. Additionally, both PMC and PHC are governed by some policies and rules, some of which are formulated by the World Health Organization. If the focus is placed on Ontario, the PHC sector supports families and individuals so that they can make the best and informed decision concerning their health. In addition, PHC in Ontario includes the provision of advice on the best and suitable strategies of promoting health and preventing diseases (Phillips et al, 2014). In as much as there are similarities between PMC and PHC, There are also a couple of differences that exist between primary health care and primary medical care. To begin with, primary medical care is often used in describing a family practice where a small number of individuals are given urgent attention. On other other hand, primary health care is a broader term that usually encompasses the wider selection of people such as providers of health care (Phillips et al, 2014). PHC also includes the function and services of other stakeholders and how they aspire to achieve these goals. Sometimes, primary health care is regarded as a bracket of health care that is founded on the principles of offering fair and accessible to almost all people.            Secondly, PHC endeavors to remain relevant to the people by ensuring that their medica needs are met (Pype et al, 2014). Primary health care differs from primary medical care in that it is more cost effective and uses various forms of technology to provide quality care to patients. The World Health Organization plays a very instrumental role in ensuring that all children and adults can be able to access quality and affordable health care (Pype et al, 2014).  This is achieved by following their policies and rules that are part of their mission. PHC also takes into account the demographics and population index of various places so that it can know how best to serve people in a given area (Jenstad and Donnelly, 2015).  There are numerous explanations that continue to be given for both primary medical or health care. The fact remains that both are distinctly different and they should not be used interchangeably.

 

 

Describe the rationale behind the belief that primary care is a critical component of improved integration.

The Ontario health care system is amid one of the best medical systems in the world. Residents who qualify for this health system have the privilege  to access various kinds of health care facilities in their community (Jenstad and Donnelly, 2015).  In Ontario, citizens are given a medical health cover insurance that will cater for their medical needs during emergencies. There are various ways of getting non-emergency medical care in Ontario. One of them is by trained medical staff answering the patients’ questions via phone (Giltenane et al, 2015). Family doctors, nurses and other health care providers are usually the ones in most cases concerned with checking out and attending to patients’ medical complications. Primary health care is a necessity for an improved medical integration, and an example can be seen in treatment for chronic diseases like cancer, heart complications, kidney failures, and many other diseases.

In most countries, primary health care is practiced by nurses, and other health providers (Thomas et al, 2015).  In preventing chronic diseases, multiple guidelines have been developed to help general physicians in the avoidance of Chronic diseases. The prospective role of general practice comprises the identification and delivery of brief interventions to avert chronic disease and also the referral to other facilities and programs. A number of industrialized nations have introduced and embarked on healthcare reforms, these reforms is aimed at improving their systems of delivering primary health care (Jenstad and Donnelly, 2015). With the introduction of medical reforms, many people are able to access primary medical care and the rate of their attendants increased.

Launching a more rational basis for referrals and taming the coordination between primary care and specialist doctors making primary care practice more interesting and rationally fulfilling. Nations should embrace the distribution of both primary care and specialists by modifying their authorizing rules to health requirements in different areas or by providing financial enticements for practicing in harsh areas, as is done in some other nations. Primary care is a necessity and so ways of improving it must be incorporated (Mundt et al, 2015).  Allocating more funds to facilitate research in primary health care will be of great help in the expansion of this service, as this will benefit many people in the community.

Discuss the key roadblocks that must be addressed and what can/should be done

Delivering worthy patient care is aim number one for most medical practices, but good objectives are not constantly enough if your management progressions keep falling apart (Ngiap et al, 2014).  Fort Wayne Medical Education Program (FWMEP),  family health program in Indiana came up with several road blocks that hindered the administration of primary health care, and possible ways on how to overcome them  Some of these roadblocks that must be addressed within the Ontario health and reform system are presented below:

Scheduling visits more effectively

As a busy practice seeing 100 patients a day, FWMEP has to quickly look for possible solutions on how to attend to patients and especially those with acute health problems. First, and foremost, WMEP created fifteen appointment slots, each taking place morning and afternoon hours (Jenstad and Donnelly, 2015).  Secondly, The exercise established two brochures that focus on the need for preventive  care, one for young teenagers and the other for adults (Ngiap et al, 2014). Usually, these services were offered to patients and parents during their  appointment periods, and the exercise plans to widen delivery services to patients who are not planning on performing preventive exams frequently.

 

Providing two visits in one

One major obstacle to executing a double visit procedure was the absence of coding and reimbursement skills amid the medical practice. To curb this, doctors were taught how to clearly deal with both services in the patient’s electronic health record and correctly code them with the use of modifier 25 to show that a major, separately distinguishable service was delivered on the same day (Jenstad and Donnelly, 2015). At first, this resulted to consternation, but after few weeks of practice, a careful evaluation discovered that adding ten minutes to accommodate well-child checks was not troublesome and in fact improved the treatment time.

Reducing missed appointments

To handle the  roadblock of missed appointments, the practice should take a detailed overview of mails sent by patients to their physicians for those who did not make for their ideal appointment day.  For instance, FWMEP found out that though they requested patients to reorganize for their appointments, the mails did not have any information on how to contact these patients (Mundt et al, 2015).  The practice came up with a new mail highlighting the practice’s contact numbers and e-mail address, so that the doctors could communicate with patients and know why they missed their appointments. FWMEP also got the support of AmeriHealth Mercy of Indiana, which promised to handle communications when patients missed three or more appointments (Mundt et al, 2015). The practice also reviewed its method for appointment approval phone calls. Even though patients will get appointment notices from an automated system two days before their planned appointment, they must be reminded on that specific day their appointment will occur, and most patients will be contacted in the morning.

 

 

Increasing newborn care

To avoid postpartum and preliminary newborn care from subsiding through the cracks, the doctors deliver hospital care to moms and children (Thomas et al, 2015). In addition, they have to use the discharge paperwork for each of their patients to one of the two triage nurses employed by the practice. The nurse follows up straight with the patient to program the newborn and postpartum appointment (Ngiap et al, 2014). Patients get an automated an approval call two days prior these appointments. The practice is making an allowance for the emergence of a postpartum and nursery standing-order sheet to train hospital ward workers to review the exercise earlier before the patient is cleared from the hospital to plan for the postpartum and newborn check-ups (Ngiap et al, 2014).

Positive results

The new scheduling conventions which include welcome calls to new patients, approval calls for all well-child checks and postpartum follow-up calls, were tabled in by earlier staff after reshuffling and relocating jobs. Using a system that makes enhanced utilization of  providers’ time, instead of the addition of more hours, the practice’s volume and revenue both improved (Chrystal et al, 2015). Most significantly, kids are getting the preventive, primary care they require. This advantage has proved that refining outcomes may contain much more than revising what goes on in the exam room (Phillips et al, 2014). Enhanced aftermaths may well depend upon uncovering and eradicating the barriers a practice makes, and  how it succeeds in accessing it.

Conclusion

Primary care is vital for building a durable health care system that warrants positive health outcomes, usefulness and competence, and health impartiality. It is the first interaction in a health care system for people and is embracing coordination and completeness. It offers  individual, community-oriented and family-focused  care for treating, preventing, or improving common infections and disabilities, and supporting health. In both developed and developing countries, primary care has been proven to be connected with enriched access to health care services, improved health aftermaths, and a reduction in hospitalization and use of emergency unit visits. Primary care can also aid in offsetting the negative effect of poor economic conditions on health. Thus, the research recommends the necessity to intensify the supply of primary care physicians globally.

Alternatively, research has pointed out that nations and regions more focused on the primary care have lesser healthcare expenses, but improved health outcomes, though advance studies using formal cost-effectiveness ways need to be piloted. Cost-effectiveness of primary care has been purposely recognized through a limited interventions performed in primary care settings, and embracing of health information systems in primary care settings may lead to improved  financial achievements.

 

References

Chrystal, J. G., Glover, D. L., Young, A. S., Whelan, F., Austin, E. L., Johnson, N. K., &             Kertesz, S. G. (2015). Experience of Primary Care among Homeless                                               Individuals with Mental Health Conditions. Plos ONE, 10(2), 1-14.                                       doi:10.1371/journal.pone.0117395

Giltenane, M., Kelly, M., & Dowling, M. (2015). Public health nurses’ (PHNs) experiences of                   their role as part of a primary care team (PCT) in Ireland. Australian Journal Of             Advanced Nursing, 32(3), 6-15.

Jenstad, L. M., & Donnelly, M. (2015). Hearing Care for Elders: A Personal Reflection on                        Participatory Action Learning With Primary Care Providers. American Journal Of Audiology, 24(1), 23-30. doi:10.1044/2014_AJA-14-0051

Mundt, M. P., Gilchrist, V. J., Fleming, M. F., Zakletskaia, L. I., Tuan, W., & Beasley, J. W.                     (2015). Effects of Primary Care Team Social Networks on Quality of Care and Costs for Patients With Cardiovascular Disease. Annals Of Family Medicine, 13(2), 139-148.          doi:10.1370/afm.1754

Ngiap Chuan, T., Chirk Jenn, N., Rosemary, M., Wahid, K., & Lee Gan, G. (2014). Developing               a primary care research agenda through collaborative efforts — a proposed      “6E” model.     Asia Pacific Family Medicine, 13(1), 1-13. doi:10.1186/s12930-014-0017-9

Phillips, J. P., Petterson, S. M., Bazemore, A. W., & Phillips, R. L. (2014). A Retrospective           Analysis of the Relationship Between Medical Student Debt and Primary Care Practice in             the United States. Annals Of Family Medicine, 12(6), 542-549. doi:10.1370/afm.1697

Pype, P., Peersman, W., Wens, J., Stes, A., Van den Eynden, B., & Deveugele, M. (2014). What,             how and from whom do health care professionals learn during collaboration in palliative       home care: a cross-sectional study in primary palliative care. BMC Health Services        Research, 14(1), 247-266. doi:10.1186/s12913-014-0501-9

Thomas, K., Krevers, B., & Bendtsen, P. (2015). Implementing healthy lifestyle promotion in                   primary care: a quasi-experimental cross-sectional study evaluating a team initiative.            PMC Health Services Research, 15(1), 650-669. doi:10.1186/s12913-015-0688-4

a topic report about the following

 

Health

What are the roles of the federal Public Health Service?What does the Surgeon General do? What does CDC do? How is each organized? What regulations do they each enforce and what policy do they each make?

 

Topic Report Format:

14-page (double spaced)report using 12 point Times New Roman font, standard margins

Proper in-text citations
and list of Sources Consulted in
A
P
A
f
o
rma
t
.
Pages will be numbered and each section will have the heading in
bold print.
Be sure that all the points in each section listed below are covered in your paper.

 

The paper will have the following topic headings typically found in academic reports, and be used as dividing points within the paper:

 

Background:
description of issue or program (
typically 4 pages
)

Methodology:
description of the method you used to create the analysis(see Rosenbloom’s

discussion of program evaluation methods, lecture on program analysis) (
1-2 paragraphs
)

Literature Review: 
what did you read about your topic that was written by other authors? Write it as an essay with citations, not as an annotated bibliography (
2-3 pages
)

Analysis:
the impacts of this issue in the context of the political situation, community situation, societal concerns, preceding/ existing policies or programs; who were the stakeholders involved in the policymaking and how was the balance of power represented in the policy development outcomes so far. The analysis must both
support your recommendation and acknowledge all sides of the issue
(e.g., opposition, alternatives)(
6-

8 pages
)
.
Be sure to include appropriate references to C
onsti
tu
t
i
on
a
l and l
ega
l
i
ssues
re
lat
e
d to
y
our topic.
Remember that this is a RESEARCH REPORT, not an argument or legal brief, so you are providing a balanced and supported view, not arguing!

Conclusion:
Summarize the significance of the topic
tied to your analysis
. (
1
p
a
r
ag
r
a
ph
).

 

The paper will be evaluated using the following criteria:

 

Criteria

P
oints

a) The professionalism with which the report is presented: clarity, appearance, grammar,

spelling, appropriate word choice, “voice”.

3

 

 

b)The comprehensiveness and care with which the topic being analyzed is described,

including citing the appropriate Constitutional and legal issues.

4

 

 

c) The demonstration of understanding of relevant public administration concepts that

can be used to explain the topic and its context, impact, and policy outcomes.

5

 

 

d)The quality of
analysis providing links between class discussion and readings 
and the topic

6

 

 

e) The quality of critical thinking demonstrated in the Analysis section
.

6

 

 

f)The
appropriateness of the references
selected
and the analytical bridge to the paper

topic, including correct in-text and sources consulted citations.

4

g) The APA format was properly used for all citations

2

TOTAL

30

 

EACH STUDENT WILL WRITE AN INDEPENDENT PAPER

Topics Report   

 

Because the text focuses on federal public administration, the research papers will have a
state and local government focus
. Resources include academic journal articles,credible non-academic periodicals such as
The Economist, NewYorker, Time
, academic analytical books, staff reports and government documents on the topic, newspaper articles and editorials about the topic, and interviews of elected and appointed officials familiar with the topic. The paper will be written in academic report format,
with a “Sources Consulted” list and appropriate citations throughout.

 

 

 

 

 

Federal Public Health Service, Surgeon General and CDC

Name:

Instructor:

Date:

 

 

Background

The health system in the United States has witnessed tremendous growth over the years. We have come know it is a system that is perhaps the most developed as well as effective across the world. However, what most individuals within the United States and beyond do not understand is that the health system is complex as it can get. Indeed, one could say that this has contributed to its success in ensuring a healthy nation while also putting the country at risk. This is because the many interconnected components must function as expected at all times to ensure that we have a healthy nation. Often, the health systems comes out as involving all public and private as well as voluntary entities that have contributed to the delivery of vital public health services within the United States jurisdiction. In fact, the concept of health system oversee that the various components or entities contribute to the health as well as wellbeing of the society. Once, the health system in the country was viewed as consisting of official/government public health entities but such a perception has transformed over the years to include other public sector entities (for instance schools, land-use agencies, environmental protection entities) as well as private-sector agencies. This has meant that the health system in the country is involved in various works meant to ensure public health. From educating the public on injury prevention through monitoring outbreaks of diseases and implementing initiatives to curb their spread, the public health system make the lives of those living in the United States safer as well as healthier. People may not realize it but the health system is ever-present in citizens’ lives. Indeed, at some point in one’s life health system is all but important. This includes pregnancy, at birth, and throughout childhood and adulthood. This is because health system involves the efforts, art, science, as well as approaches that are used by different sectors of society to oversee assurance, maintenance, protection, promotion, and improvement of people’s health. In fact, the health system in the United States goes past assuring the conditions of public health because the inclusion of private-agencies means that businesses and employers, academic, the media and others play a critical role.

As signified above, the mission of the health system revolves around promoting the physical and psychological health of communities as well as populations, to prevent ailments, injury, and disability. This means that the health system may focus of a smaller number of individuals as evidenced through the integration of local/state level agencies. The health system in developed countries such as the United States becomes a complex as well as multi-faceted web with the common aim of protecting the health of a population. It is noted that this system comprises of an infrastructure that enables delivery of services to the masses. In the United States, the infrastructure allows the crucial public health functions to be undertaken and comprises of myriad units and or organizations. For instance, within federal’s department of HHS (Health and Human Services) there are various agencies including the primary ones for public health such as the CDC (Centers for Disease Control and Prevention), the NIH (National Institutes of Health), HRSA (Health Resources and Services Administration), FDA (Food and Drug Administration), as well as AHRQ (Agency for Healthcare Research and Quality). As far as public health policy is concerned, primary leadership rests with the Surgeon General –the chief of the United States Public Health Service- as well as the CDC (California Health Policy Forum, 2007). Whilst most federal public health activity falls under HHS department, a number of agencies in public health are also involved. This includes USDA (United States Department of Agriculture), OSHA (Occupational Safety and Health Administration), EPA (Environmental Protection Agency), Department of Defense and others. Worth noting, is that there are responsibilities for public health functions at various levels of government including state and federal. Most authority, however, is at the state level. Often, the federal government influences public health practice by funding decisions as well as setting national policy. This translates into providing leadership as well as shifting focus on public health challenges. On the other hand, states engage in numerous activities to protect public health. These activities range from safety enforcement as well as sanitary codes to carrying out inspections and mandating the reporting of various illnesses to state authorities. In addition, such activities as compelling quarantine or isolation and licensing facilities and workers are undertaken at the state level. Regularly, states delegate authority for various functions to local governments at the forefront in responding to health emergencies.

Evidently, the public health system governing the country is complex and inter-agency relationships are at the core of its success. In fact, not one agency functions in isolation because the core aim remains to protect the population against diseases that continue to threat societies across the world. The department of HHS thus works together with various agencies meant to ensure public health. An in-depth look at some of the agencies and their roles in ensuring overall public health can reveal the manner in which the agencies are interlinked. Worth noting, is that their policies may seemingly be structured differently but the core aim of ensuring public health overrides. Some of the components that will be explored in this paper include the Surgeon General, the federal Public Health Service, as well as the CDC. These agencies lie at the center of United States’ health system and are some of the most important in protecting the public against diseases and ensuring wellness. Altogether, public health remains a global issue and the United States is no exception. It is in the best interest of a country to ensure that her citizens remain healthy. The United States is among the many nations that adopted United Nation’s declaration on health (California Health Policy Forum, 2007). The declaration accepts that citizens’ health is a human right that ought to be preserved by the governments.

Methodology

The methodology used in this paper to analyze the aforementioned agencies involves exploratory research. This methodology has been chosen because the areas of study are not only wide but also the fact that the intention is to merely explore the given questions. Often carried out to determine the nature of a problem, the methodology used in this paper is meant to provide a clear picture of the agencies under focus. This means that such a methodology is crucial to making people understand a problem and or answers to a question. A number of considerations are made when using this methodology including the researcher’s willingness to change direction due to revelation of fresh information and or insights. In particular, exploratory methodology of research is handy in situation where a researcher has an idea about a given topic (s) and embarks on a journey to understand it better. This has seen exploratory methodologies of research labeled as initial research because they involve laying the groundwork for better understanding of an issue or a topic. Often, exploratory methodology of research involves questions that necessitate insight and this may include new topics. Worth noting, is that new angles about a topic can result out of fresh information found through exploratory methods of research. This includes new theoretical perspectives as well as fresh ways of measuring something. Nevertheless, the tactic that will be employed in this case involves article reviews. The tactic will include extensive search for related materials in academic databases as well as respectable publications over the Internet. Such sources often provide researchers with rich sources of information that can be built upon to answer questions. This will be helpful in providing insight into the agencies including their roles, organization, relationships, as well as the kind of policies they make or enforce.

Literature review

Scutchfield and Keck (2003) claim that one of the most crucial federal organizations in public health, involves the public health service. This is an arm of the federal security agency. In fact, the public health service assisted the creation of state health departments through giving grants-in-aid, providing advice and consultation on various problems, as well as loaning expert personnel. For instance, if a specific state was witnessing an unprecedented outbreak of disease the public health service would make available exerts to trace the starting place. This included suggesting means of dealing with the spread of an illness. Scutchfield and Keck (2003) insist it must be said that a key stimulus to the growth of public health practice came in response to the challenges associated with the Great Depression through the New deal as well as 1935s Social Security Act. Out of the public health viewpoint, the Social Security Act signified a significant step forward. As Scutchfield and Keck points out, title v of this act provided for an initiative of grants to states including child health services among others. In addition, title vi expanded financing of the public health service as well as allotted federal funds to states assisting them to develop the public health services. Nevertheless, Halverson et al (1998) claim the public health service in the United States has an established history of providing health care services. Established in 1798, the agency grew to become the predominant unit in charge of developing public health programs, sub-agencies, as well as services at a federal level. This underlines its role in the public health system, and it is evident that the agency is among the most crucial in the U.S. in fact, the services are designed to not only examine the health status of the nation but also to meet the identified needs in the health system. In 1996, the public health service agency was recognized and placed under the DHHS to play the role of creating a more efficient as well as client service-oriented unit. Altogether, these are some of the key roles played by public health service agency.

The Surgeon General’s role in the American health system is also crucial. A longstanding docket in U.S government history, Surgeon General previously played the role of heading the Public Health Service including all programs, financial management, as well as administrative duties. Satcher (2015) notes that this changed in 1968 and in modern times, the Surgeon General serves as United States’ chief health educator through providing citizens the best scientific information on improving health as well as minimizing injury and illness risk. According to Ray (2014), the modern roles associated with Surgeon General include articulating scientifically based health policy examination as well as advice to the government (especially HHS secretary) on the full variety of crucial public health system challenges facing the country. Another crucial role played by Surgeon General involves administering PHS commissioned corps – a uniquely flexible and expert career force of health professionals- who are ready to respond to long-term and short-term health needs of the public. Ray (2014) also notes that Surgeon General’s roles include providing leadership as well as management supervision for commissioned corps’ involvement in emergency preparedness as well as research properties. Another role involves fulfilling statutory as well as regular departmental representational responsibilities on a range of federal panels and governing units of non-federal health agencies such as the National Library of Medicine, American Medical Association, Armed forces Institute of Pathology, and Association of Military Surgeons. Altogether, these are some of roles for Surgeon General.

CDC is renowned in the country and beyond for its crucial role in ensuring public health. Halverson et al (1998) contends that the agency mission revolves around promoting health as well as quality of life through preventing and controlling injury, disease, as well as disability. It has centers across the country and some of its roles include providing statistical information for guiding actions as well as policy to support the health of the citizens. This role is through a division known as the National Center for Health Statistics. What is more, CDC’s roles include running the all-important National Center for STD (sexually transmitted disease), HIV (human immune-deficiency virus), and TB (tuberculosis) prevention (Brunette, 2011). This division plays a particularly crucial role in the health system because it provides surveillance, prevention studies, as well as programs to prevent and or control STDs, HIV infection, and TB. Halverson et al (1998) also notes that CDC’s roles include prevention as well as control of disease, birth defects, and disability resulting out of association between individuals and the environment. This is achieved through its division known as the National Center for Environmental Health. In addition, the agency has a division named the National Center for Injury Prevention and Control, which establishes programs for reducing injury, disability and related costs, as well as death outside the workplace. Another role associated with CDC is strengthening the community observation of public health via information networks, overseeing laboratory quality, and via conducting practice research. This is achieved through CDC’s International Health Program division or office. The National immunization program, on the other hand, is tasked with immunization programs throughout the country. In sum, CDC roles are wide-ranging and sometimes may focus on such groups as infants and adolescents with the core aim of promoting health. This includes promoting healthy personal behaviors among citizens.

Analysis

The federal public health service, as aforementioned, is crucial to the functionality of the health system as a whole. Its roots can be traced back to the colonial period in the United States when there were repeated epidemics of such diseases as cholera, smallpox, and yellow fever. For instance, an epidemic in Philadelphia in late 17
th
century nearly shutdown the federal government and such health crisis brought about the idea of municipal boards of health. These boards comprised of respected citizens who were authorized to act in society’s interest in implementing quarantine, evacuation, as well as other public health interventions. Indeed, early role of the federal government in combating diseases led to modern-day U.S public health service. It was established as the Marine Hospital Service that continued to evolve to include a range of public health services including sub-agencies, programs, as well as services. The services were designed to examine nation’s health status. In the mid-1990s, the goal accelerated towards a more efficient as well as client service-oriented agency and the public health service was not only reorganized but also placed under the all-inclusive domain of DHHS. As far as its organization is concerned, the agency is well placed in the health system of the nation to assess public health needs and provide for means to meet them. The agency is directed through the Office of the Secretary as well as the Deputy Secretary who oversee the Assistant Secretary of Health, the Assistant Secretary of Management and Budget, Planning, and Evaluation Assistant secretary, Legislation Assistant Secretary, as well as the Assistant Secretary of Public Affairs. Worth noting, is that the Office of the Secretary directs several key public health agencies including Administration on Aging and Administration for Children and Families. The organization can be classified into four major units including the NIH, the Office of the Surgeon General, the Bureau of Medical Services, as well as the Bureau of State Servicers. The federal public health service has come a long way to its present state in terms of regulations involves. The New Deal as well as the Social Security Act of 1935 can be viewed as some of the foundations leading to this agency. As an example, title VI of the Social Security Act provided for expanded financing of the public health service agency. In fact, federal as well as state expenditures for public health increased significantly immediately following the Great Depression. In turn, this fueled expansion of local or state health units. In recent times, the agency was recognized trough the Public Health Service Act (1944) in which the federal government sought to introduce compact as well as orderly arrangement of existing regulations related to public health. Thus, some of the regulations that are made and or enforced by the agency include providing authority to make grants in aid to research companies for study of a disease. What is more, the agency authorizes expansion of all federal-state public health programs including calling for the establishment of specific control programs such as those involving tuberculosis. Altogether, it is evident that the federal public health service occupies a central role in the public health system because its policies are far-reaching both at federal and state levels.

An analysis of the Surgeon General docket ought to include public health service agency because for many years it headed the agency. The focus revolved around controlling infectious diseases, which was significant to safeguard American soldiers who were located in endemic areas and to safeguard the American public once infected soldier returned home. However, the focus of Surgeon General changed after the creation of the Department of Health, Education, and Welfare –later the DHHS. The Surgeon General reported to the secretary of Department of Health, Education, and Welfare and later to the assistant of Department of Health, Education, and Welfare. Eventually, Surgeon General was awarded back the responsibility for the public health service. The aim was to ensure that an office in the long administrative line of the health system would assume the role of overseeing public health focus (Haley and Kreek, 2015). In fact, the modern office of the Surgeon General involves issuing reports from time to time calling to action or communicating on matters of significance to the health of the citizens. In essence, Surgeon General is within the health system to help it focus on matters that continue affecting the public health system. For instance, modern times have seen Surgeon General associated with helping the American public to act on such matters as alcoholism and smoking. Without a doubt, these represent some of the key issues affecting the health of American people. In terms of organization, Surgeon General’s office falls under the Public Health Service agency within the all-inclusive DHHS. In fact, Surgeon General’s office is one of the several administrative units under the Public Health Service. What is more, the organization of this office includes a Deputy Surgeon General as well as up to three Assistant Surgeons General who are tasked with several bureaus. Staff officers with the position of Surgeon General’s assistant are responsible for the administration of sanitary and dental engineering activities. Indeed, U.S Coast Guard’s Medical Director has the position of assistant Surgeon General within the Public Health Service. This reveals the fact that the Surgeon General occupies a significant position in the country’s health system. Seeing that Surgeon General’s office is within the Public Health Service agency, laws or regulations governing the latter apply to Surgeon General. These include the Public Health Service Act, which has far reaching significance as far as public health matters are concerned. The Surgeon General is associated with creation of virtually all policies on public health in the country. This is because the office is expected to generate reports from time to time detailing the challenges the public health system faces. Nevertheless, the fact that the Surgeon General is involved in public health leadership at the highest level by serving as an advisor to the government (especially the secretary of Health and Human Services) indicates the office’s involvement in policy enactment. In addition, the office oversees regulations governing Public Health Service’s commissioned corps and informs the country about crucial public health issues. In fact, all Surgeon Generals have been involved in public health policy formulation through championing specific issues. For instance, Talley and Travis (2014) note that Surgeon General J. B. Richmond championed for formulation of “Healthy People” policy on exercising, environmental factors, and nutrition.

CDC is among the most crucial agencies in the public health system of the nation. This is because the agency can be attributed to health practitioners needs to improve association between academic and the practice community as well as to ensure competent public health. This includes a competent workforce capable of delivering public health services. It opened the doors in mid-1940s as the Communicable Disease Center. It was a new component of the Public Health service. Initially, the agency was concerned with controlling the spread of malaria in the country but it great to include many other crucial roles over the years. In fact, the agency is the leader in public health matters as enshrined in its mission to collaborate to develop the expertise, information, as well as tools that communities require safeguarding their health (Public Health Reports, 1944). In particular, the 19
th
century saw the agency come of age through continuing applications of classic field-oriented epidemiology and via the development of fresh methodologies. As an example, the disciplines of decision sciences and health economics were merged to generate a fresh area of emphasis in prevention effectiveness. Worth noting, is that such an approach involved making rational choices about public health interventions. This indicates that recent years have seen the agency more involved in prevention strategies of public health. Nevertheless, a number of legislations over the years have contributed to CDC’s emergence as a leader in public health locally and globally. These include the crucial Public Health Service Act, which has far-reaching significance in U.S public health system. In fact, under section 361 of the act the Secretary of Health and Human Services has authority to undertake measures meant to safeguard the entry as well as spread of communicable diseases. In turn, the authority for undertaking such functions has been delegated to CDC. Indeed, the federal regulations authorize CDC to not only detain but also medically analyze as well as release individuals entering the U.S. This also includes individuals travelling between nations who may be suspected to have communicable diseases. On the other hand, states have police authority functions to safeguard the health, safety, as well as welfare of citizens. This implies that states have regulations to enforce the use of quarantine and isolation, and breaking such orders is often a criminal misdemeanor. What is more, if quarantinable illnesses are identified or suspected, CDC enforces policies on federal isolation and or quarantine order. The agency is falls under Health and Human Services domain, which is an inclusive department with secretaries and deputy secretaries. As with other agencies and units in the Public Health Service line, the core aim is to oversee public health improvement. In sum, CDC occupies a key area in American health system and collaborates with other agencies in DHHS to protect the health of all citizens.

Conclusion

The Health and Human Services domain in the U.S is wide-ranging and it remains crucial to the wellbeing of Americans and beyond. More so, it contains such crucial divisions as the Public Health Service, Surgeon General, as well as the CDC. These agencies, as evidenced in this paper, are crucial to delivery of health services to the population. They play numerous roles in delivery of health services to the public including developing as well as applying illness prevention and control, occupational safety as well as health, and environmental health. This includes injury prevention as well as overall health promotion. Worth noting, is that the various agencies collaborate to ensure that quality healthcare is delivered to American population. The various divisions must function as one entity to ensure that the core aim of ensuring a healthy America is realized. This brings in the idea of a system in which the federal public health service, Surgeon General, as well as the CDC play crucial roles in ensuring effectiveness. Nonetheless, the role are often undertaken at the federal level but can be delegated to state levels in which actors or sub-units engage target groups and communities. This paper has evidenced that the different divisions or agencies have evolved over the years to become effective, as we know them. Thus, it can be predicted that transformations in their roles will continue to evolve as the country seeks to come up with a model most likely to minimize or eliminate issues facing the health system.

 

References

Scutchfield, F and Keck, W. (2003). Principles of public health practice.USA: Cengage    Learning.

Halverson, P et al. (1998). Managed care and public health. USA: Aspen Publishers.

Talley, R and Travis, S. (2014). Multidisciplinary coordinated caregiving. USA: Springer Science & Business Media.

Public Health Reports. (1944). Public Health Service Act, 1944. Retrieved from             http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1403520/pdf/pubhealthrep00059-   0006.pdf

California Health Policy Forum. (2007). Understanding the United States public health system.    Retrieved from             ttp://www.cahpf.org/godocuserfiles/207.chi%20brief%20united%20states.pdf

Satcher, D. (2015). The past and future office of the Surgeon General. Annals of Internal             Medicine, Vol. 162 Issue 6, p 450-451.

Ray, L. (2014). The role of the Surgeon General. Retrieved from http://woman.thenest.com/role-  surgeon-general-14602.html

Haley, S and Kreek, M. (2015). A window of opportunity. American Journal of
Public

Health
,     Vol. 105 Issue 3, p 457-463.

Brunette, G. (2011). CDC health information for international travel 2012. USA: Oxford University Press.

Plein, C. (2014). An uncertain federalism. Journal of
Health
&
Human
Services
Administration.   Vol. 37 Issue 3, p 350-377.

The topic is Obsessive Compulsive Disorder (OCD) in Adults.

Detailed Paper (18 Pages double-spaced in APA Format. Page requirement includes title page, abstract, and reference page)

The paper sections:

1) the development and course of the disorder,

2) cerebral localization,

3) neurotransmitters involved,

4) genetics,

5) treatment (including pharmacotherapy),

6) current controversies about the biology of

the disorder and the appropriate next steps

for researchers to take to resolve them.

 

Obsessive Compulsive Disorder (OCD) in Adults

The majority of psychological conditions that are observed in clinical cases are known to mainly affect adults.  People in age extremities such as the too young or the too old do not often suffer from these diseases due to their dormant lifestyle.  Adults are the main targets of psychological conditions because they have a very active lifestyle, are fully developed and have many responsibilities that they are required to accomplish.  Obsessive Compulsive Disorder or OCD is one of the most common psychological diseases that affects most adults.  This disorder is often characterized by thoughts that are intrusive, leading to constant worry, anxiety and obsession.  The affect adult will exhibit behaviors that are repetitive, so that he or she can try to reduce the anxiety or obsession being felt.  This paper is a comprehensive essay that focuses on Obsessive Compulsive Disorder in adults.  The essay will address the causes of this disorder, the treatment and the controversies that surround the biology of this disease.

The development and cause of Obsessive Compulsive Disorder

Obsessive Compulsive Disorder or OCD is defined as an anxiety and apprehension disorder that is mostly characterized by repetitive behaviors that compel a person to behave in a bizzzare manner (Dell’Osso et al, 2013).  These behaviors are often caused by unwanted thoughts that make the actions being done to be uncontrollable (Thomsen, 2013).  Most adults who suffer from OCD have obsessive thoughts and compulsive behaviors which other people will define as being irrational, since they do not make sense at all (Weber et al, 2014).  For example, it is very normal for a person to counter check if they have unplugged the iron box from the socket after they have finished an ironing session.  It is also normal to go back and check if the car is locked after packing it outside a shopping mall.

However, for a person suffering from OCD, their behaviors become too compulsive and obsessive such that they interfere with their normal daily life (Thomsen, 2013). For instance, a person with Obsessive Compulsive Disorder will check the cooker twenty times just to make sure that they have switched it off.  Another person will opt to wash their hands by thoroughly scrubbing them to a point of almost peeling the skin just to ensure that the hands are clean (Vakili and Gharraee, 2014).  In fact, OCD is so serious that if a person happens to be driving and comes across a bump, they will go round the same road fifty times just to confirm to themselves that they did not run over a person.

The main cause of Obsessive Compulsive Disorder has been linked to both psychological and biological factors in a person’s body that lead to the development of the disease (Tucci et al, 2014). Nonetheless, these factors will differ from one individual to the next depending on the degree of emphasis on either one of the two factors. The psychological cause of OCD is brought about by overly obsessive behaviors that make a person to become pre-occupied with a certain habit or activity (Gordon et al, 2013). For example, the constant washing of hands as a way of affirming hygiene, hoarding of personal belongings, even if they are no longer useful or even making the bed after every five minutes even if no one has laid on it. On the other hand, the biological cause of OCD is linked to abnormal functioning of certain neurotransmitters in the brain (Dittrich and Johansen, 2013).

Neurotransmitters are chemicals that are involved in the transmission of a synapse or chemical message from one neuron to another target nerve cell (Gordon et al, 2013).  In the case of OCD, the defective neurotransmitter is usually serotonin, which is very important in the regulation of anxiety in the body (Dittrich and Johansen, 2013). Therefore, a person or adult who suffers from OCD will always be in constant fear that something is not right and will go ahead to try and make it well by performing a given task infinite times (Gellatly and Molloy, 2014). Common Obsessive Compulsive Disorder symptoms can include the fear of being contaminated with dirt or germs or even passing these contaminants to others. This is why most patients with OCD will wash their hands so seriously that they can even cause them to have sores (Gellatly and Molloy, 2014).  Other people will have excessive thoughts on morally upright or pious issues that they will often regard other people as impure, sinners or evil. Obsessive Compulsive Disorder becomes a problem because it interferes with the daily life and normal relationships, causes immense distress and takes up a lot of useful time.

b) Cerebral localization of the disorder

Obsessive Compulsive Disorder is a disease that is capable of afflicting a person throughout their entire lifetime. The brain of people suffering from OCD is somewhat different from their normal counterparts. People with OCD have significantly less white matter in their brain as compared to normal subjects. This was evidenced through a preliminary study that was conducted in parts of the brain of people with OCD using Magnetic Resonance Imaging or MRI (Souza et al, 2014). The white matter is an important component of the central nervous system within the brain and the spinal cord as well. It contains important cells, such as the glial cells and axons that contain the myelin sheath. It is through the white matter that signals are transmitted from one end of the cerebrum to other places within the brain center (Fairfax et al, 2014).

The white matter in OCD patients is usually much less and that is why it interferes with functioning, cognition and processing. What’s more, the white matter acts as a relay that passes on information from the brain’s cerebrum to different areas of the body (Fairfax et al, 2014).

The white matter lies beneath the cerebral cortex and contains nerve cells that connect other neurons within different areas in the brain. People suffering from OCD often have abnormal rates of cerebral activity that directly affects their metabolic rates. The severity of this disorder attacks the frontal lobe and the basal ganglia within the orbital cortex, which then stimulates a worry circuit or signal (Fairfax et al, 2014). This is what is seen as the obsessive disorder that makes most OCD patients worry a lot about their hygiene, safety or even property. The orbital cortex is able to stimulate and ignite a worry circuit because is contains a caudate nucleus that helps it to switch from one line of thought to another (Moradi et al, 2014). This process is then enhaced by the thalamus which processes the body’s sensory inputs. Researchers have also postulated that Obsessive Compulsive Disorder can result from lower levels of neurotransmitters in the brain.

c) Neurotransmitters involved in OCD

It is clear that Obsessive Compulsive Disorder is caused by certain biological disorders that affect the functioning of the brain (Moradi et al, 2014).  In particular, these disorders affect the neurotransmitters in the brain and cause them to transmit the wrong information. Neurotransmitters or NTs are chemicals that are involved in the relaying of information or signals across a synapse (Moradi et al, 2014). They do this through the use of nerve cells or neurons that are located within the brain. Once they are released from the brain, NTs are packaged in the form of a synaptic vesicle that is then clustered under the membrane in the axon terminal. From here, they are able to bind to receptors in the synaptic cleft and they can then pass across the opposite side of the synapse (Souza et al, 2014).

The most common neurotransmitter is acetylcholine which is involved in controlling most of the body’s synapses. In healthy or normal people, information is usually transmitted through the central nervous system through the combination of chemical and electrical signals (Souza et al, 2014).  The neurotransmitters are able to travel from one neuron to the next and in the process, they relay information relating to moods, emotions and feelings. There are special receptor chemicals that are prepared to receive these messages from the neurotransmitters  (Souza et al, 2014).  This process continues from one nerve cell to the other until the relevant signal is relayed. In adults with Obsessive Compulsive Disorder, the neurotransmitters are defective and are not able to function as they should. The main neurotransmitter involved is usually serotonin, which is usually under some form of chemical imbalance. It is capable of cutting of the normal sequence of signal communication within the brain so that comminucation failure results.

This is because serotonin is reabsorbed or sucked into the nerve cells before it is able to  cross over to the synapse. This then causes chemical signals and messages to be lost due to the sucking back of the serotonin neurotransmitter. This is what causes the symptoms of OCD to develop due to the malfunctioning of the transmission of a synapse. The brain scans of people who suffer from Obsessive Compulsive Disorder show varied patterns of brain activity when compared to their normal counterparts. In OCD patients, there is a very different form of  neurotransmitter circulation within specific parts of the brain. In other cases, the neurotransmitter dopamine has been linked to the cause and development of OCD. Research has also shown that people with OCD can have inconsistent levels of dopamine and serotonin in certain parts of the brain’s cerebrum. Scientifically, these conditions are termed as hypofunctioning of the serotonergic activity within the basal ganglia and the hyperfuctioning of dopaminergic activity in the frontal cortex.

Serotonin is a neurotransmitter that is responsible for the regulation of anxiety. This chemical is normally found in the platelets of the blood, the brain and nervous system as well as the gastrointestinal tract or GIT (Peterson, 2012). In addition to anxiety, serotonin is believed to be responsible for making people feel happy and excited with themselves. However, most of the serotonin is located in the brain where it regulates other activities such as sleep, appetite, mood and happiness. The depletion of serotonin is what is responsible for the Obsessive Compulsive Disorder. Some researchers in an Italian university have linked the depletion of serotonin in people who have recently fallen in love (Peterson, 2012).  Such people normally exhibit symptoms of obsessive behavior in the early stages of love. For instance, some people will call their partner every five minutes, send them text messages in an overly frequent manner or keep checking on them if they work or study in the same place.

On the other hand, dopamine is responsible for a number of functions within the human body. For instance, dopamine regulations the activity of most hormones so that people can behave in a normal manner. For people with Obsessive Compulsive Disorder, the neurotransmitter dopamine is not well produced and these results to abnormal functioning of most hormone dependant activities. This then translates to the patient feeling bad about themselves, insecure and even unclean (Peterson, 2012). This is what becomes visible as the obsessive habit of trying to make themselves feel good about themselves by washing excessively, counter checking on people and even confirming if things are in  the right place in an excess manner.

d) Diagnosis and Treatment of Obsessive Compulsive Disorder

                                    (including pharmacotherapy)

The treatment for Obsessive Compulsive Disorder can only be done if the clinical psychologist or clinician understands the symptoms very well. The signs of this disorder include both the compulsive and obsessive symptoms. In general, the symptoms of OCD  are normally persistent, repetitive and highly unwarranted. The person suffering from OCD often thinks that getting rid of the obsession is the best way to solve the issue. Instead, this becomes a problem because it becomes an intrusion, especially when other things have to be done. Obsessive symptoms can include the fear of being contaminated with dirt, having horrific and aggressive thoughts that can lead to some people harming themselves, wanting things to be always perfect, symmetrical and orderly and even having unwanted thoughts on religious and sexual issues. These signs are what makes OCD patients to fear shaking other people’s hands because they will be contaminated. It is also the reason why some people will doubt they have switched of the kettle or shut the windows at night.

For the perfectionists, they are obsessed that their things must face a certain way. Some people will want their clothes to be arranged facing a certain direction in the wardrobe. When it comes to foods, they will want the canned or bottled goods to face the same way. Interestingly, most adults with Obsessive Compulsive Disorder think that  their behaviors make a lot of sense.

The most effective treatment for Obsessive Compulsive Disorder is cognitive behavioural therapy. This mode of treatment involves two main components which are the cognitive therapy bit and the second part  is exposure and response prevention. Cognitive therapy focuses its efforts on the distractive and horrific thoughts that most OCD patients normally have.

This mode of therapy aims at helping the patient to fill their minds and thoughts with more positive content so that they can avoid resorting to compulsive behavior. On the other hand, exposure and response prevention involves the constant exposure of the person to the source of a given obsession. For example, if a person has the obsession of hygiene and they are always cleaning their hands, the person can be made to touch a dirty surface then be prevented from washing their hands. Next, the patient can be made to sit somewhere for a while and with time, the urge to wash their hands will gradually fade away. With time, the person will realize that their compulsive behavior can be controlled without employing any obsessive or compulsive behaviors.

Pharmacotherapy is also another mode of treatment for adults with obsessive or compulsive behaviors. The modern approach used in pharmacotherapy began in the late 1960’s when some drugs such as clomipramine was shown to be effective in treating OCD (Klein et al, 2013). This mode of treatment was later adopted to involve the mechanism of drug action of clomipramine  (Lihua et al, 2014).  This is a non-selective chemical that enhances the re-uptake of serotonin during a synapse. Pharmacotherapy can also involve selective serotonin reuptake inhibitors or SSRIs such as paroxetine, fluoxetine and citalopram (Jacob and Storch, 2013).

Both the selective and the selective re-uptake inhibitors where developed due to the deficiency in the functioning of serotonin among OCD patients  (Lihua et al, 2014). Therefore, these drugs normally function by blocking the uptake of serotonin during the pre-synaptic stage. In turn, this increases the availability of serotonin at the postsynaptic receptors.

Clomipramine is the most intensively studied drug for the treatment of Obsessive Compulsive Disorder  (Lihua et al, 2014).  This drug has a couple of chemical properties that give it the ability to enhance the functioning of serotonin within the body. Apart from clomipramine, several other selective re-uptake inhibitors have been tested and proven effective in treating OCD. For instance, celexa has shown to be highly effective in treating Obsessive Compulsive Disorders in adults  (Lihua et al, 2014). Pharmacotherapy can also involve the use of anti depressants although not all of them are effective in treating this disorder. Desipramine is a very effective antidepressant that has been used to treat symptoms related to compulsive and obsessive disorders.The rate of success of this drug has led to most psychologists recommending this drug to people with OCD related symptoms. However, the use of any drug is bound to have its own adverse drug reactions that differ depending on the efficacy of the drug and the lethal dose.

Clomipramine is the most effective selective re-uptake inhibitor for serotonin, but it has its own share of side effects. For example, this drug is known to cause seizures and some forms of heart conductivity problems. The risk of clomipramine related seizures increases if the lethal dose of the drug exceeds 250 milligrams. On the other hand, antidepressants such as desipramine have been known to cause nausea, constipation and dryness of the mouth. Therefore, the  preferential drug to be used for pharmacotherapy should be evaluated based on the adverse drug reactions of each medication as well as the body metabolism of a patient. The common denominator for all of these drugs is to enhance the activity of serotonin in the nervous system. Since most neurons are normally separated from each other by a synapse, a neurotransmitter has to be released into this synapse so that a signal is passed across it. Therefore, when this process is blocked or restricted, it results in a number of disorders one of which is OCD.

As such, both selective and non-selective re-uptake inhibitors have the mechanism of inhibiting serotonin being drawn back into the pre-synaptic membrane. Ultimately, these drugs have been shown to be effective in the treatment of Obsessive Compulsive Disorder. There are other alternative methods that are used in the treatment of Obsessive Compulsive Disorder in adults. Most psychologists as well as psychiatrists recommend a number of activities that can help a person to overcome OCD. First, they should relabel themselves by recognizing that the intrusive actions and obsessive thoughts are being caused by the disorder. Therefore, such a person should try telling himself or herself the opposite of what they always feel compelled to do. For instance, a patient with OCD can train their minds to say that their hands are not dirty and they should not have the urge to wash them.

Secondly, the Obsessive Compulsive Disorder patients should reattribute themselves and realize that the severity of the thoughts or urges they have are actually caused by a chemical imbalance in the brain. In such a case, the person should confront the disease by saying that the obsessive thoughts are not being caused by themselves. Instead, they are being caused by false messages being transmitted from the brain, making them act in a bizarre manner. It is also important for OCD patients not to take the thoughts caused by the disorder at face value and instead focus on things that are more productive. They should regard these thoughts as senseless obsessions that have no meaning at all. Therefore, they should ignore them and pay no attention to them. Clinical psychologists have also developed different forms of family therapy, since this disease usually affects families and societies.

The symptoms that are exhibited by OCD are known to cause heart aching problems that affect the life of the individual, the immediate family members and society as a whole. Consequently, family therapy can be helpful in promoting the understanding of this disorder and help affected family members to reduce conflicts with the affected person. Psychologists encourage family members to treat the sick member in a lovable way, motivate them to become better and heal from the disorder. There are also self-help tips that can be applied in combination with pharmacotherapy or cognitive therapy. Patients with OCD should divert their attention from the strong urges and obsessions to other helpful activities. For instance, they can listen to music, read, go for a walk or jog or even prepare a favorite dish. The importance of doing this is to delay the response to that particular compulsive though that the patient can have.

The outcome of this delay is that the urges become less intense than it was in the first place. Therefore, the longer this urge is delayed, the easier it becomes to forget and eventually refrain from engaging in the habit. Since the disorder is often caused by problems of anxiety, a healthy lifestyle should be adopted to try to reduce this fear and anxiousness. Patients with Obsessive Compulsive Disorder should exercise regularly, have ample rest and observe a healthy balanced diet. Cognitive behavioral therapy is a form of cognitive therapy that can be used to regain the control of the behavior of OCD patients. This mode of treatment works under the principle that thoughts are responsible for causing anxiety. Therefore, these thoughts can be altered by using a number of behavioral responses that will eliminate anxiety. Different forms of therapy will work at varying levels depending on the patient. Some patients will respond successfully to one mode of treatment will others may show no change at all. The first step in successful treatment of this disorder is accepting that one has the disease. This will then be followed by searching for the appropriate mode of treatment that will be effective in the end.

e) Genetics of Obsessive Compulsive Disorders

The psychological condition of Obsessive Compulsive Disorder has been shown to be hereditary and can be passed down from a parent to the progeny. Genetically speaking, OCD is caused by a mutation in the gene that is responsible for anxiety and worry. This mutation has been located in the human serotonin transporter gene, which is known as hSERT and occurs in families with OCD. Identical twins can also be at risk of developing OCD because they contain a hereditary factor that controls neurological anxiety. Patients with ICD are much more likely to have their firstborns developing the disorder since they are the first progeny in the hereditary tree. If Obsessive Compulsive Disorder develops during the childhood stage, the genetic links become much stronger than if the disorder was to develop during adulthood.

The genetic factors of OCD  account for approximately seventy percent of the symptoms that are observed among adults. The genetic factors of OCD  are also affected by environmental parameters, which interfere with how the signs of this disorder are expressed. There is a genetic link between this disease and its occurrence in different environments  (Gomes et al,  2014).

OCD has also been shown to affect close relatives of people who previously suffered from this disease. The genes that are of great intrest in OCD are those that control and regulate the serotonin and dopamine neurotransmitters in the brain. The genes behind these neurotransmitters can be linked to the strong inheritance of this disorder  (Gomes et al,  2014). There is also a group of researchers  who have identified a genetic marker that is responsible for causing Obsessive Compulsive Disorder.

The cause and mechanisms of  OCD are poorly understood despite the disorder being the fifth common psychological condition in the world. A genome related study has been conducted where the genomes linked to OCD have been scanned and compared to those of healthy people  (Gomes et al,  2014).  The findings revealed that there is a deletion mutation in the genes of people with OCD that caused them to have obsessive and anxious moments. OCD as a psychological disorder has a genetic architecture that has many different genes and they can be as many as one hundred in one individual.  The identification of the specific genes that predispose a person to the risk of inheriting OCD are still being researched on to date. These studies involve a genome wide research that endeavors to find the specific target genes and compare them to the controls. In addition, there is also the genome wide trait analysis that compares genetic variation across the entire OCD genome.             This method is able to test multiple OCD  sites at one go and can also estimate the proportion of  heredity of this disorder.  The preliminary results of this study have showed that the level of heredity of this disorder is as close as what was predicted in the families of people with a history of OCD .

f) Current controversies about the biology of the disorder and the appropriate next             steps for researchers to take to resolve them.

The biggest controversy behind the biology  of OCD lays the medical approaches that have been used to treat the condition. While some researchers believe that the re-uptake inhibitors are highly successful, others believe that the chemicals only worsen an already serious condition. Obsessive Compulsive is a condition that has had numerous clinical explorations in an exponential manner. However, the research in the biological factors of the disease continues to witness disagreements in the advances that have already been made. The recent findings concerning the heredity of this disorder and the identification of certain presumed subtypes continues to elicit different reactions. In addition. The development of sophisticated theoretical models to help understand OCD has until recently been the topic of discussion.

Despite these controversies, the efforts research has put into understanding the nature of the disease should be appreciated. The advances in its treatment now range from medical attention to changes in cognitive behavior. However, these modes of treatment are not always effective to every OCD patient and that is why they have brought a lot of controversy.

There are a couple of steps that researchers are taking to ensure this disorder is transformed from the unmanageable condition it is to a problem that can be managed. Psychologists now view OCD as a disease that can be treated and help increase the quality of life of the affected individual. The disciplinary lines between cognitive behavior and biology of OCD remain the most common areas that are researched on when it comes to this disease.

Scientists are aware that medical approaches have been highly valuable in explaining the biological processes of OCD. In addition, the psychological formulations of OCD only emphasize the vital role of dysfuctional and  learning cognitions. Regardless of these facts, the empirical findings from each theoretical speculation are gaining a diverse range of perspectives.

There have also been controversies surrounding some of the symptoms that come with OCD in adults. Compulsive hoarding is one of the serious signs of this disorder and involves the storage of unnecessary items. This usually results in cluttering and untidiness of the living area and is brought about by distress or impairment by the OCD patient. This symptom causes a lot of controversy since there are many people who have the habit of hoarding their items and yet do not suffer from OCD.

It is this controversy that has led to a fresh line of new and  exciting research so as to increase the understanding of this syndrome. This issue has since continued to be debated upon and has led to newer advances regarding compulsive hoarding. Researchers have concluded that this hoarding is usually brought about by the obsession to collect as much property and items as possible. People with OCD will often believe that throwing away their belongings makes them evil and inhuman. Therefore, their thoughts will always tell them that keeping these things is a sure way of showing the world that they are good people. However, this behavior should not be confused with people who often prefer to keep their belongings in the garage as a way to remember their valuables.

In another angle, controversies also exist in areas where literature concerning the disease remains unclear, under-developed and contradictory. For instance, it still remains unclear if OCD  should be categorized purely as an anxiety disorder or it should be considered as a different type of disorder. Secondly, there are many controversies that surround the existence and understanding of paediatric OCD. In addition, psychologists are yet to agree on an optimal mode of treatment for this disorder since different patients will respond differently to all the various types of treatment. Some people are still in doubt when it comes to combining pharmacotherapy with other ways of psychological treatment (Melca et al, 2013). Researchers are of the view that this approach is highly successful as it combines both biological and psychological healing (Melca et al, 2013). It has already been shown that the use of chemical drugs to compensate for the failure of serotonin neurotransmitter aids in the reduction of OCD  (Martinelli et al, 2014).

In addition, it is able to contain anxiety and feelings in OCD patients, which is the main cause of the disorder. Despite these disagreements, research is looking at how best to disseminate the results of the evidence-based treatments (Melca et al, 2013).

The potential role of autoimmune related disorders that are associated with certain bacterial infections has also been linked to OCD. This is quite contradicting since literature states that the only biological cause of this disease lies in the malfunctioning of the neurotransmitters (Melca et al, 2013). What’s more, the structure of the disorder as well as the subtypes are a source of disagreements among most psychiatrists. The relative contributions of genetics versus the environmental factors are well known to be risk factors for an individual to develop OCD. However, this knowledge is not entirely conclusive and it is still under close scrutiny (Thomsen, 2013).

g) Conclusion

Obsessive Compulsive Disorder is a  serious psychological condition that affects mainly adults across the globe. The condition is mainly characterized by a severe obsession and compulsive behavior that makes people engage in weird behavior. In addition, this disorder causes the affected person to perform a certain habit or activity in a repetitive or persistent manner without getting any form of returns from it. For example, most OCD patients will wash their hands so thoroughly that they can end up getting blisters and serious scars. They wash their hands to a serious extent because they think that their hands are dirty and may contaminate their bodies or people around them. OCD usually begins as an obsession that simply refuses to go away. It arised from the need to eradicate a given urge that is brough about by inner feelings that the person wants to sustain. Obsessive Compulsive Disorder can be caused by psychological factors as well as biological problems. The psychological cause is brough about by the paerson feeling inadequate, dirty, insecure and threatened. That is why a person can counter check if they have switched off the kitchen cooker twenty times even if they stopped cooking more than six hours ago.

In terms of biological causes, OCD is attributed to the malfunctioning of certain neurotransmitters such as serotonin and dopamine. Neurotransmitters are important chemicals that relay information between the pre and post synapse. These chemicals are usually released from the cerebrum of the brain and their absence results in serious mood, feeling and emotion disorders. For the case of OCD, serotonin is the most common neurotransmitter that usually malfunctions in most people. It is released from the brain, but is not able to pass across the post synapse. Therefore, most treatment options focus on enhancing the role of serotonin in OCD patients. Selective and non-selective re-uptake inhibitors work by restricting serotonin from being drawn back to the pre-synaptic membrane. Instead, they ensure that this chemical messenger is able to pass through the fluid filled synapse into the postsynaptic area.

Several forms of therapy such as pharmacotherapy have been used to treat OCD. This form of treatment employs drugs that enhance the activity of serotonin and dopamine. However, these forms of treatment can only be effective if the patient adopts a healthy lifestyle. In addition, they can also engage in activities that will divert their attention from the obsessive habits. There are current controversies about the biology of this disorder that have made researchers focus their time in resolving them. For example, the genetic issues regarding OCD are yet to become fully conclusive. The genome for OCD is being sequenced so that the active genes responsible for the disease can be identified. However, it is clear that this disorder is hereditary and can be passed on from parent to offspring. What’s more, a close relative is at risk of developing this disease since they are within the family tree of the OCD patient. It is anticipated that ongoing research will bring a lasting solution to solve the fourth common psychiatric illness across the globe.

 

 

 

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