An Effective Alternative for Treating Lower Back Pain Wayne State University Health Clinic 5200 Anthony Wayne DriveSuite 115Detroit, MI 48202

An Effective Alternative for Treating Lower Back Pain
Wayne State University Health Clinic 5200 Anthony Wayne DriveSuite 115Detroit, MI 48202

Heliotrope Enterprises
Executive Summary
Lower back pain is a common symptom prompting clinic visits in the University. The standard treatment is pain-relieving medications and rest from exertion but current trends in health care point to the increasing use of complementary and alternative medicine (CAM) in the treatment of lower back pain. The use of CAM is motivated by patients’ desire to avoid the side effects of frequent pain medication use. However, many CAM modalities only result in short-term pain relief which decreases patient satisfaction with these treatments.
The Bowen technique is a promising alternative modality for treating lower back pain. It is deemed effective, especially over time, based on its long use since its development in the 1950s. As such, the Wayne State University Health Clinic commissioned a research project to obtain evidence of Bowen technique efficacy which will be the rationale for adopting the technique as an alternative treatment for patients with lower back pain in the future.
This report presents the results of the study done to establish the efficacy of the Bowen technique based on secondary and primary data. A literature review was undertaken showing that pain relief is experienced in 1-3 treatment sessions and generally is sustained over time. Further, email interviews of 10 randomly selected certified Bowen practitioners in the state were done to see if the treatment is effective specifically for back pain based on their experiences. The main results of the study are as follows:
– There were 428 patients treated for lower back pain in the last year.
– Pain symptoms usually abated within 1-3 sessions in more than 50% of the patients; differences in the number of sessions are due to individual factors.
– Symptom improvement tended to continue over time and majority eventually achieved total lower back pain relief.
– Of those who experienced complete relief from pain, most had no more need of further treatments for lower back pain.
– Slightly more than a third of patients returned for maintenance treatment of lower back pain and is mainly due to reinjury, chronic conditions and noncompliance.
Findings of the primary research corroborate the findings in literature which builds strong evidence for the positive outcomes of the treatment. Thus, the Bowen technique is a safe and effective therapy for lower back pain which should be adopted by the University Health Clinic and combined with patient education to address unrealistic expectations, compliance and prevention of reinjury.

Lower back pain is a major health complaint in the U.S. In its latest report, the CDC reveals a 30% incidence among American adults in a 2009 survey (National Center for Health Statistics, 2010). Lower back pain can significantly affect the performance of daily activities including work. It increases the number of sick days which correspond to lost economic productivity. The experience of pain considerably reduces the quality of life. It is no wonder that there is a high demand for effective treatment of lower back pain. Conventional treatments consist mainly of medications which can threaten health especially when taken long term. Hence, alternative techniques are better options. Although people obtain full pain relief from alternative modalities, the major complaint is that pain comes back after awhile. Therefore, there is interest in finding an alternative technique that provides relief over time.
The Bowen technique is one alternative treatment that is widely utilized today. Its popularity among alternative treatment practitioners and patients alike is largely due to the fact that it is not invasive, has no side effects and provides long-term pain relief compared to other treatments (Lofting, 2003). This is beside the other benefits gained from the technique’s holistic approach. The modality was popularized by the internationally-recognized Bowen Therapy Academy of Australia and is represented in our country by the Bowenwork Academy USA. The technique is presently governed by quality standards achieved through training and accreditation, the latter provided by the Academy in Australia (Bowenwork Academy USA, 2011). Currently, there are 369 accredited Bowen practitioners in the U.S. with 72 based in California, 47 in Washington, 28 in Texas, 26 in Michigan, and 26 in Oregon.
This report concerns an evaluation of the Bowen technique in terms of its efficacy in relieving pain for longer periods. It aims to provide first-hand evidence validating its efficacy over time as stated by patients and practitioners. Hopefully, the results will initiate more research interest on this modality and further establish the technique as a treatment for lower back pain. Specifically, this report will discuss the following:
– Development of the Bowen technique and how it works
– The Bowen technique as an alternative and non-invasive treatment
– Efficacy of the Bowen technique for back pain within 1-3 sessions based on case studies in literature and the results of primary research
– Percentage of patients coming back after pain level reach zero is supported by case studies in literature and the results of primary research
– The second research method
– Future directions for research on the Bowen technique
The evaluation is accomplished through a literature review as secondary research. Case studies and reviews on the outcomes of Bowen technique utilization in various patients were searched and retrieved from reputable websites, as well as from the ScienceDirect and EBSCOhost databases. A search of relevant books from the perspective of health care professionals yielded one for reference. Primary research was done through email interviews of Bowen technique practitioners using a randomly selected sample of those affiliated with the Bowenwork Academy.

Section I. Background of the Bowen Technique
The Bowen technique is internationally recognized as a complementary and alternative medicine (CAM) modality. Specifically, it is a type of body manipulation treatment, a category of CAM which utilizes either pressure, touch or movement of parts of the body as techniques (Snyder & Lindquist, 2006). With the persistent problem of back pain in the population and the costs and side effects of using pain relievers, it is important to widen the options of patients regarding treatment. The following discussion describes how the Bowen technique was developed and how it actually works.

Development of the Bowen Technique
The Bowen technique or Bowenwork is a therapeutic modality utilized for pain relief. Its development was undertaken by Tom Bowen, a masseur who had a long history of treating athletes and laborers in Geelong, Australia (Brief history, 2012). The most common complaint of his patients was body pain owing to their strenuous physical activities. Bowen used his expertise in massage therapy to relieve the pain of his patients. In his extensive practice, he noticed that there seemed to be a connection between the pain symptoms arising from musculoskeletal injury, problems involving the nervous system, and various Fig. 1 Tom Bowen other health conditions (Brief history, 2012).

How the Bowen Technique Works
The soft tissues most relevant to the Bowen technique are those that involve the muscles and nerves. Receptors located in these sites relay messages to the brain setting in motion the body’s natural ability to heal by repairing worn out or injured tissues, efficiently using nutrients, eliminating waste, ensuring adequate blood flow, permitting lymph drainage, keeping nerves healthy, and maintaining adequate muscle length (The Bowenwork, 2012). An important outcome of Bowen therapy is deep relaxation, a state of remarkably reduced stress that sets the stage for healing. Therapy, whose duration may range from as short as 15 minutes to as long as one hour, eventually results in decreased muscle tension, improved ranges of motion, reduced inflammation and relief from pain (The Bowenwork, 2012).
The Bowen technique is characterized by rolling movements aimed to slide skin over the soft tissues that lie beneath (Genders, 2006). These moves are accomplished using the fingers along with the application of light pressure to specific parts of the body that have been delineated by Tom Bowen in his decades of practice as the areas that trigger specific body responses (The Bowenwork, 2012). The use of gentle pressure is the hallmark of the Bowen technique setting it apart from massage therapy which uses deep pressure. The pressure used in Bowen treatment is considered a mild stimulus which contributes to its high efficacy. An explanation for this is provided by the Arndt-Schultz law adapted to Bowenwork from the field of medicine. It states that in an individual, only an ideal amount of stimulation can bring about optimal results and usually, it is minimal stimulation that works better than strong stimulation (Knight & Draper, 2008).

Fig. 2 Different Bowen moves
The moves are followed by a rest period which allows the body to fully respond before the next moves are done (Genders, 2006). Wellness is achieved as treatment draws on the innate power of the body to restore itself leading to an abrupt and often long-term resolution of pain and other symptoms. It also recognizes that individual responses vary so that the practitioner must adjust treatment to accommodate the unique responses of patients and for this reason, patient assessment is done prior to treatment (Marr et al., 2010). Initial therapy usually consists of two sessions held weekly but further sessions may be needed. On the average, it would take three to eight treatment sessions for most health problems to completely resolve (The Bowenwork, 2012). The technique has been noted to be useful in treating more than 60 symptoms and conditions.

Section II. The Bowen Technique as an Alternative Non-Invasive Therapy
Compared to conventional pain therapy, which may be delivered through injections, and other alternative treatments such as acupuncture, the Bowen moves are not invasive. This means that the skin, acting as the body’s major protective barrier from the external environment, is not breached. In contrast, the use of injections to administer medications and the utilization of needles for acupuncture both penetrate the layers of the skin.
When proper infection control procedures are not taken, penetration of the skin can facilitate the entry of harmful microorganisms into the body (Injection safety, 2012). A non-invasive therapy like the Bowen technique has many advantages. First, the possibility of developing infections is zero since the skin is not breached. Second, there is no pain associated with treatment. Third, the likelihood of other complications such as tissue injury is virtually none.

Section III. Literature Review
A search of previous studies on the Bowen technique was done using Cinahl and ScienceDirect journal databases. Search terms used were Bowen technique/therapy/treatment/modality and lower back pain. The studies retrieved describe the efficacy of the Bowen technique specifically for back pain and also the people returning for retreatment due to pain recurrence.

Efficacy of the Bowen Technique for Lower Back Pain
The efficacy of Bowen therapy has been documented in literature. James (2008) documented the case of two older adult patients who benefited from the modality. One had extreme lower back and left hip pain owing to problems with the pelvic bone. He had poor posture and difficulty with movements of his arms and legs. After 30 minutes of initial Bowen treatment, he could stand straight and move with ease minus the pain. The other patient also had chronic lower back pain which limited her activities and subsequently developed depression. After initial treatment, her mood significantly improved along with her pain. Two more treatments totally relieved her pain and stabilized her mood. The study validates the pain-relieving effects of Bowen therapy. These case studies show that Bowen treatment can effect pain relief immediately after the first treatment session and that full resolution of symptoms is achieved during the third treatment.
In her book, Genders (2006) also describes two cases of children with cerebral palsy wherein the Bowen technique was effective. Decreased muscle tone, difficulties with balance and coordination and swallowing problems are some of the physical manifestations of this condition while low attention span, sleep disturbances and delays in speech development are some of the psychological and mental signs. Both children received a series of Bowen treatment sessions which resulted in marked and steady improvements in many of these signs. Most notable is the technique’s capacity to enhance musculoskeletal functioning even among children. The children’s parents were able to notice improvements right after the first treatment, again showing that the effects of Bowen therapy are immediate.


Research Paper On The Social Role Of Fur Rubbing In Capuchin Monkeys

Research Paper On The Social Role Of Fur Rubbing In Capuchin Monkeys

The white-headed capuchin is an animal that is usually active during the day and inhabits trees (Emmons, 1997). It, however, goes down to the ground frequently than other monkeys (Morris & Bruce, 2005). It locomotes primarily through walking on all four limbs. It resides in groups, or troops, of about 40 monkeys and its ratio of male to female adult sex, is 71 on average. With unusual exceptions, females pass their whole lives with their female colleagues. Males move to new social groups many times throughout their lifetimes, moving for the first time between the first 20 months and 11 years of their age (Jack & Fedigan, 2004). Males, at times, move alone, but more frequently, they move in other males’ company who are usually their kin. Among the strange features of the white-headed capuchin kinship structure that is relative to other species of primates is the high level of relatedness within groups. These are caused by the long terms of alpha males who generate most of the children.
Kinship is an essential organizing aspect in the organization of social relationships of female-to-female. In larger groups, females preferentially relate with, groom, and offer support to their matrilineally associated female kin. They do not show a similar predilection for their fatherly half sisters that might mean they are only able to recognize kinship through the motherly line. Supremacy rank is as well an essential organizing aspect, with females more frequently grooming and relating to females closer to them in the hierarchy of dominance. Coalitionary aggressiveness is common in both males and females, and capuchins appear to have an outstanding apprehension of the coalition structure in their group. For instance, when capuchins are in a combat, they wisely recruit assistance from those who are both in a higher ranking than they are and better friends with themselves than with their rival (Perry, 1997).
Female capuchins possess linear hierarchies of dominance. Unlike in other monkeys where females socially acquire the rank just below their mothers and just above their subsequent oldest sisters, capuchins do not possess a highly predictable ranking within their motherly lines. Males are usually dominant to females. Male-male relations are tense, and association between males is characteristically expressed by playing, resting in contact, or non-impregnable sex instead of grooming (Perry S., 1998). Males work together in coalitions versus potential predatory animals, and in the group’s defence versus other males. Occasionally, coalitionary aggression of males turns into violence and males are murdered, especially if they are found wandering the forest without the company of allies. Since aggression from other males is the primary death cause, male allies are vital in self-defence when migrating and helping in usurping other groups. Emigration of males to a new group typically takes place approximately every 4 years. Therefore, the majority of males are in steady risk of having to defend themselves against other male groups (Fedigan & Jack, 2004).
Males that are migrating frequently kill young children when they take control of a group. Females group together to protect their children from males who are infanticidal, but they hardly ever succeed in rescue their infants. Since infants hinder their mothers from ovulating through frequent nursing, males manage to bring females into estrus before through murdering the children and thus ending nursing. This increases their breeding chances. Females frequently mate with their infants killers of, and gradually, they support new alpha male like the previous one. The alpha male protects females from subordinate males in the group and other groups’ infanticidal males.
Even though, they participate in territorial activities, it has recently been indicated that White-faced capuchin troops tend to be aggressive to other troops of White-faced capuchin. This is in spite of their meeting point, and the aggression is not inevitably with an intention to prohibit the other groups from a particular home range (Fragaszy, Visalberghi, & Fedigan, 2004). Groups with many males are advantaged over those with fewer males, but the locality of the confrontation within the home range also counts. Smaller groups overcome larger groups if the competition occurs at the centre area of home range of the smaller groups.

Background Information
When they have a chance, capuchin monkeys pursue fur rubbing by use of tissues from animals that are soft-bodied or plants, which are strong and physically stimulating. Typically, monkeys initially influence the material for fur rubbing, for example, tear it apart or bite into it, then put a part of the material into one arm and massage it with fast movements of the arm on their whole body as well as the back, tail, legs, flank and arms. The capuchins that are white faced may possibly drool excessively throughout such rubbing sessions (Fragaszy, Visalberghi, & Fedigan, 2004). They as well twist their tails around others. Fur- rubbing may be carried out by one or more monkeys, usually the whole troop or small groups. The monkeys perform fur rubbing by use of materials like Clemantis, Citrus, Sloaneaand Piper in the wild (Baker, 1996) or onions tobacco, and vinegar in confinement (Ludes & Anderson, 1995).
Rubbing fur is in general, linked to medicinal roles in capuchin monkeys since it seems to keeps away ectoparasites and ameliorates general condition of the skin. A number of evidences show support of this opinion. For instance, there was an observation that untamed crowds of capuchin monkeys that are white-faced demonstrate considerably more sessions of fur rubbing throughout the wet period when humidity and high heat may raise the bacterial infections risk. Additionally, the plants chosen for rubbing fur have secondary substances with anti-inflammatory, antiseptic and insecticidal features (Huffman, 1997). Several other species of primates have as well been discovered to pursue rubbing fur, counting spider monkeys (Campbell, 2000) and owl monkeys (Zito, Evans, & Weldon, 2003). The spider monkeys indicated many differences to capuchins. There was a report that no rise in sessions of fur rubbing in the wet season, a limited body area rubbing and a raised likelihood of rubbing fur in male monkeys (Campbell, 2000). It further suggested that rubbing fur might have a smell marking instead of a medicinal role in spider monkeys.
Many alternative roles of rubbing fur have been proposed, which include organization of scent of a group, strengthening of social unit or social grooming enhancement (Baker, 1996; Huffman, 1997). Certainly, rubbing fur seems to be enhanced socially in capuchins that are white-faced (Meunier, Petit, & Deneubourg, 2007), and social facets are frequently accentuated in experimental reports. For instance, capuchins that are white-faced with no material for rubbing fur flock around those monkeys, which has the material for rubbing fur and rubbed their bodies on their counterparts with the material on their fur. This results in an accumulation of wet, salivating monkeys, wriggling and rolling around and over one another. It is most likely that the social interactions and tolerance underlying in these shows, strengthen social units and might result in a rise in positive relations between members of the group. In a comparison between the behaviour of rubbing fur in tufted and white-faced capuchins in confinement, it was discovered that white-faced capuchins’ fur-rubbing conduct was more communally adjusted than that of the tufted capuchins. This study hypothesized that rubbing fur may facilitate social unity in capuchins that are white faced and not in the tufted monkeys (Leca, Gunst, & Petit, 2007).

In an experiment to investigate the social role of fur rubbing in Capuchin Monkeys, study animals included sub adult animals, tufted capuchin monkeys, as well as adult animals. On top of these, juveniles and infants were also included but were not regarded as central subjects, although they were part of the propinquity measures for central animals. Every study animal was kept in an open-air field augmented with ladders, swings and perches. There was no deprivation of food and supplements of seeds, nuts and fresh fruits were provided every day. Monkey biscuits and water were provided ad libitum.
Monkeys were monitored one time a day and five times in a week. By Use of main animal sampling, data was collected on each monkey in six sessions, thrice in the apple condition and thrice, in the onion condition. In sessions of onion, a single yellow onion was cut four times and split into single layers to make 30 pieces that were put in a prominent stand inside the enclosure. During the sessions of apple, there was cutting of the apple into four pieces and chopping it in order to look like the pieces of onion, and was put in the same stand. In every session, an arbitrarily chosen animal was monitored for 45 min after the supply of onion or apple pieces. By use of the Pocket Observer, other animals’ proximity, the intervals of affiliative behaviours were continuously recorded and, because of their comparative short periods, the occurrence of focal animals’ aggressive acts was engaged. The interactions time of focal animals with pieces of apple and onion, were recorded, and the time of any rubbing of fur. The experiment was sanctioned by the relevant agency.

Monkeys showed interaction in different manners with apples and onions. There was strong control of apples by the female and alpha male, who collected armfuls of pieces of apple and then pulled away to a far platform to eat these pieces. Some monkeys did not obtain pieces of apple during the experiment. Besides finishing the apple for a short time, there was no manipulation of the apple by monkeys, but they ate it immediately, to make the standard apple interactions’ duration 1 min 27 sec. Apple pieces interactions were mainly limited to the first period observation. On the contrary, the female and alpha male would take just one or two pieces of onion and without delay begin manipulating, consuming as well as rubbing fur on a similar stand. Monkeys frequently tore larger pieces of onion apart and dropped smaller pieces that were then gathered up by others. Every monkey got pieces of onion at least one time during the experiment. Additionally, by use of onions for rubbing fur, monkeys as well consumed the onion, or controlled it by busting it apart, biting into it or whiffing it but spewing it out once more.
The non-rubbing fur uses were carried out for an average of 4 min 42. Some fur-Rubbing monkeys pursued in fur rubbing throughout their three sessions of onion. Others indicated fur-rubbing behaviour in just one or two sessions of onion. Sessions that had no fur rubbing were thrown-away from the analysis. All adult female monkeys did not show fur rubbing in spite of controlling and consuming onion pieces. Among the monkeys that showed fur rubbing, the standard fur rubbing duration was 4 min 33 sec. The majority of fur rubbing happened throughout the first period of observation. Other monkeys showed fur rubbing in the second period of observation, and just one monkey in the third period.


Research Paper On TelemedicineBringing Medicine Closer to Patients

Research Paper On TelemedicineBringing Medicine Closer to Patients

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Telemedicine: Bringing Medicine Closer to Patients
It is safe to assume that life is now easier with the invention of technology, especially the availability of the internet. Most businesses and activities can now be done in the internet for those on the go and would need some time to bond with friends or settle important paperwork. Nowadays, only a few people do not have access to the internet and stick to the traditional method in doing transactions. For medicine, it has slowly adopted technology and the internet to give quality service to patients. Normally, patients would have to pay hundreds of dollars because of hospital bills and additional fees, making patients stay out from hospitals if they can. However, with the introduction of the internet, medical experts have devised methods to enable patients to receive quality medical care while in their own homes. This breakthrough is known today as Telemedicine. Although many find it awkward to use computers to speak with their doctors, telemedicine has enabled patients to save a lot of money and be monitored regularly by their doctors no matter where they are in the globe. It has also allowed medical practitioners to learn, update, and follow the current trends in medicine despite their locations.

The term “telemedicine” was incepted in 1970, meaning healing from a distance. This directly emphasizes the use of ICT to improve health in various parts by giving open access to healthcare. The definition of telemedicine has varied since the time of its inception and improvement. Normally, it is considered as online health-care as computers are used to access several medical services like consultation, appointment scheduling, and medical application. However, experts would agree that telemedicine is a medical service that enables people to access medical services through the use of the internet, at the same time, enables practitioners to exchange medical files and data easily. Telemedicine is not a new medicine despite its nature as an alternative medium for patients to access their doctors or medical providers. Instead, it should be referred to as a medical service that caters to general to specific medical procedure. Telemedicine is separated in various levels, depending on the application. Level 1 constitutes general procedures such as transferring medical data through the use of emails. Level 4 covers research for technologies that can be used to give medical aid. These levels can vary depending on the country’s medical concentration and technological specialty .

The history of telemedicine can be traced through the 19th century as some doctors would use telephones to transmit electrocardiograph data. The 1960s became the start of telemedicine as it was improved to accommodate commercial equipment in conducting health care. Some of the notable example from the 1960s is the use of television to conduct consultations between psychiatric specialists to general practitioners; and the use of the recorded or live video streaming to remote areas such as local medical centres. Recently, telemedicine has enabled many developments in adding ICTs to health care. Developed countries and remote areas in industrialized nations have been one of the major considerations in the inception of telemedicine and its various applications. With the digitalization of communication and the price drop in using ICTs, telemedicine has enabled healthcare providers and experts to implement efficient ways to provide care. Advancements for ICT have been improved by the introduction of the internet, enabling telemedicine to cover and utilize Web-based applications and multimedia in applying telemedicine.

Telemedicine can be applied in two types depending on the information shared and the interaction between healthcare providers or healthcare providers to their patients. The first type is the asynchronous or store-and-forward type which enables telemedicine to share recorded date between individuals in different times. This is normally seen in e-mail transcriptions sent to an expert, who would reply at a later time regarding the diagnosis for the transcription provided. On the other hand, the synchronous or real-time type enables telemedicine to present information through health professionals and experts through the use of videoconference or three-way teleconferencing. Either telemedicine application can utilize various media to transmit information. They can use text, video, sound, or photos in sharing information through the internet or other mobile methods. Telemedicine services are also not limited in general consultation and discussion as telemedicine also enables teledermatology, telepathology, and teleradiology to be done in a remote setting. These services not only utilize the internet, but it also uses mobile medical devices for remote operations.

Most of the services of telemedicine is focused on diagnosis and management. Developed countries often utilize these services and provide them to their citizens regularly as part of their health policies. Medical practitioners and providers in these developed countries also utilizes mobile monitoring devices for heath rate, blood pressure, and blood sugar levels for patients who have chronic diseases that need to be monitored regularly. Today, telemedicine is utilized by home care facilities and providers in these regions, enabling patients to rest in their homes and be treated far away from the hospitals. For developing countries and areas with limited access to hospitals and health care institutions, telemedicine enables local health care providers to link their patients to specialists to diagnose their patients properly. However, it is still being discussed today as to how to overcome the barriers that prevent remote communities to utilize telemedicine efficiently without too many fees and costs.

There are many benefits of telemedicine which is currently proven by the various medical organizations and practitioners around the globe. The first benefit is the availability of healthcare and medical services anywhere in the globe. Experts and practitioners can exchange opinions and diagnosis in both real and pre-recorded time. Patients can also be monitored regularly by experts through the use of the internet and monitoring devices even if they are not in the hospitals. Telemedicine also enables medical practitioners to become up-to-date with the recent developments and strategies in medicine and health care practice. It also reduces the cost of general services such as documentation, updating, and information sharing between hospitals and private corporations who need medical data pertaining to patients or diseases. Telemedicine also bridges the gap between healthcare providers and people who cannot access medical services such as the elderly and those from far-flung areas and impoverished regions through the use of internet and mobile equipment. Telemedicine also enables medical practitioners to access information, which is normally not available locally, such as journal articles, studies and even case studies. Information sharing is also a benefit from telemedicine as communication between medical practitioners to various individuals can be shared immediately and accurately. This benefit also adds the reduction of double examinations in chances that the information is found with lapses. Finally, telemedicine provides cost reduction and resource management as funds are allotted immediately to each sector of healthcare .

Despite these benefits, there are also limitations seen in telemedicine that raises concern in many sectors, especially in the developing regions. It is a common occurrence that technology is quite expensive for purchase for commercial use, which is why some concerns regarding telemedicine cost are put into question. There is also a question on the cost of retraining medical practitioners to use telemedicine-related items and funding these machines. There is also a problem in terms of the limitations on how telemedicine can be used in terms of the information it can transmit. Medical files and diagnosis are argued by many experts that must be maintained confidential and must not be used to blackmail or legal purposes. Some are concerned as to the people that can access these files and edit them for illegal purposes and activity. Some studies have also pointed that telemedicine may induce a rift between the patient and the medical practitioner since patients may feel that telemedicine is unable to determine the cause of their illness and provide assurance of their treatment. There is also the concern that some patients may not be able to express what they feel or what they need to their doctors while in front of the computer .

For developing countries, the issue on the perceived cost of telemedicine has been the major concern which is why several organizations such as the World Health Organization are finding it hard to apply this breakthrough in these areas. There is also a question on the capacity of telemedicine to become successful in these developing countries as there are still barriers that prevent telemedicine to be applied in local health systems. There are also accounts that show that not all health care providers and patients in these developing countries that are not open in applying modern techniques, favouring the use of traditional and indigenous methods due to the history behind its effectiveness. There are also others who cannot afford the training costs to become literate in ICT, which would be detrimental if telemedicine is applied in the area. Language and culture difference are also seen as a major barrier for application of telemedicine in these developing countries. Most developing countries also have citizens that are strictly conservative, which is why they have ethical concerns over the application of technology in medicine. Some patients also feel that telemedicine would degrade a person’s dignity as telemedicine would show those who are illiterate and those from families who are not well-off in life.

Legal considerations and technological capacity are also considered as obstacles for applying telemedicine in developing countries. For legal considerations, most of these countries does not have a legal framework in enabling medical practitioners to practice their profession in different regions with different jurisdictions. This is true in regions which have different governments in their provinces. There are also problems in policies that enable patients to be protected in terms of their privacy and data confidentiality. Several of these developing countries also have problems in policies that would properly screen medical practitioners and health care providers. Guidelines are also barriers for telemedicine in developing countries to maintain legislation and regulation. In terms of technological challenges, most of the technology used for telemedicine uses complex processes, and it would be hard to train specialists to run troubleshooting should these systems malfunction or fail upon use. Since telemedicine solely relies on these technologies and systems to provide health care to patients, it may cause cases of increased mortality or morbidity .

Although there are still lapses and limitations to the current form of telemedicine, it is without a doubt that telemedicine would open up opportunities for health-care. It may also provide a solution to the worldwide problem over the limitations of healthcare in far-flung areas, especially for those who cannot afford important medical services. Practitioners will also be up-to-date with new techniques to enable medicines and procedures to work accurately for patients. It is important to keep in mind that technology is not always used for leisure, or for a few, for illegal activity. For medicine, technology enables practitioners and experts to make medical procedures and services affordable and flexible for any patients. If the limitations are met, it is possible that telemedicine would enable people to maintain their health with less the cost, but with higher efficiency.

Works Cited
Lindenau-Stockfisch, Verena. Lean Management in Hospitals: Principles and Key Factors for Successful Implementation. Hamburg: Diplomica Verlag, 2011. Print.
Maheu, M. E-Health, Telehealth and Telemedicine: A Guide to Start Up and Sucess. New York: Jossey-Bass, 2001. Print.
Sarhan, Firas. Telemedicine in healthcare 1: exploring its uses, benefits and disadvantages. Nursing Times, 26 October 2009.Web. 8 October 2011 .
World Health Organization. Telemedicine: Opportunities and developments in Member States. Yearly Report. Geneva: World Health Organization, 2009. Print.


Abortion Essay

Abortion Essay

Abortion refers to the “termination of pregnancy before fetal viability” (Littleton and Engebretson 508). In this definition, a ‘viable fetus’ refers to one that has thrived for at least twenty weeks after conception. Abortion can broadly be classified into two categories:
1. Spontaneous Abortion: Also known as a miscarriage, this type of abortion refers to the termination of pregnancy without human interference (naturally) (Littleton and Engebretson 508).
2. Induced Abortion: This refers to “termination of pregnancy before fetal viability by medical or surgical intervention” (Littleton and Engebretson 508). This category can further be subdivided into two subcategories:
(i) Therapeutic Abortion: This is usually performed by medical practitioners due to inherent health risks that may be associated with carrying of the pregnancy or due to fetal illnesses.
(ii) Elective or Voluntary abortion: This occurs when a pregnancy is medically terminated at the request of a woman (Littleton and Engebretson 508). In this case, there are no health risks that are associated with carrying the pregnancy; rather, the woman simply does not wish to carry the pregnancy to full term and deliver the baby.
The debate on abortion has been heated and has evoked strong reactions from different segments of the population. Politicians, scholars, women rights activists, religious leaders and ordinary citizens have weighed in on the issue with varied opinions. The debate “has split whole societies into two camps, which call themselves pro-life and pro-choice” (Parliamentary Assembly Committee on Equal Opportunities for Men and Women 5). Whereas opponents (pro-life) argue that abortion should be banned, some even opposing therapeutic abortion, proponents (pro-choice) argue that abortion should be legitimized and all efforts made to ensure that women have access to amenities that can facilitate safe abortion.

For Abortion
Abortion, whether therapeutic or elective, should be legalized. Women should be allowed to make decisions on whether to carry fetuses till delivery or to abort. In case they decide to abort, the government should ensure that mechanisms for conducting cheap and efficient abortions are availed to these women.

Beneficial with Strict Regulations

Overall, with strict regulations, abortion can lead to a better life for the individual and society as a whole.

Why People are against Abortion
Despite my disagreement with opponents of abortion, they do offer reasonable points of view for their position on the issue. One of them is their assertion that “a fertilized ovum is a human being from the moment of conception onward and from this perspective, a fetus has a right to live, and a woman does not have the ability to override that right by choosing an abortion” (Alexander et al. 116). Though a sperm and an ovum are scientifically alive before conception, the only time when the two resemble a living form that can be considered human is after conception. After conception, a zygote has all the features of a human being, albeit in an undeveloped form. The only thing that it requires is nourishment from the mother for it to grow. Therefore, the zygote, just like a normal child who has already been born, undergoes development of body parts after conception. Opponents of abortion have constantly argued that the child’s right to life should be protected by the constitution, just like its mother’s right to life is.
Another strong reason given by pro-life activists to support their argument is that the same reasons being presented by supporters of abortion are the same that were presented by supporters of slavery centuries ago. In a famous case in 1857, “the US Supreme Court decided, by a 7 to 2 majority, that according to the US Constitution, black people were not legal persons” (Cain 8). According to this court, black people were not to be regarded as human beings. They were the owner’s property and he was at liberty to do whatever he wanted with them; he could purchase or dispose them off for money, or even take their lives. Abolitionists were up in arms against this ruling. They argued that it was unfair to “discriminate against an entire class of living persons solely on the basis of skin color” (Cain 8). However, supporters of slavery asked abolitionists not to compel those who wished to own slaves to give up the practice. After all, they argued, abolitionists could choose not to own slaves and leave slave owners alone.
One century and fifteen years later, the same Supreme Court ruled, by the same margin (7 to 2) “that unborn people were not legal persons” (Cain 9). According to the court, unborn persons have no human rights whatsoever, they are owned by their mothers, who have the right to do whatever they want with them, including killing them. Pro-life activists were up in arms against this ruling. The asserted that it was not just immoral but also “discriminated against an entire class of living persons solely based on their age (too young) and place of residence (womb)” (Cain 9). However, pro-choice activists asserted that pro-life people should not compel pro-choice people to give up abortion. After all, they argued, pro-life people could choose not to have abortions and leave abortionists alone. The fact that the above argument draws parallels to slavery, which was a barbaric, savage and evil crime is very compelling.
Yet another compelling argument presented by pro-life individuals is their contention that abortion contravenes most religious laws. Major religions have clearly banned abortion. For instance, the Bible, on several instances, affirms that life begins in the womb and should be protected. “For you created my inmost being. You knit me together in my mother’s womb” (New Jerusalem Bible, Psalms 139.13-16). The Bible also asks people to “speak up for those who cannot speak for themselves…….defend the rights of the poor and needy” (Proverbs 31.8-9). Being religious myself, I find this argument really compelling.

Benefits if against Abortion
Those against abortion cite several potential benefits. These reasons include respect for human rights. According to them a fetus is a human being and his or her right to life should be guaranteed. They also cite the development of a society that respects God’s teachings and is more religious as a potential benefit.

How Abortion Affects the Society (Makes it Better)
There are many reasons why abortion should be legalized. The most compelling is to save lives. Though some pro-life activists vehemently oppose any form of abortion, including therapeutic abortion, it is important to carry out the procedure on women who are at risk of losing their lives. In certain instances, doctors may recommend the termination of a pregnancy as a result of unmanageable risks. Some of the conditions that may necessitate therapeutic abortion are “high blood pressure, severe renal disease, tuberculosis, cancer, heart disease, lupus, multiple sclerosis, and a wide variety of relatively rare conditions” (502). If a woman suffering from one or more of these diseases is forced to carry a pregnancy to full term without surgical intervention, she may lose her life, as well as that of the unborn child. To save the mother’s life, it is important to abort the child.
Contrary to what some opponents say, legalizing abortion has the overall effect of reducing abortion-related deaths. When abortion is criminalized, women who are desperate to secure an abortion resort to self-induction or consult unqualified personnel. Instead of visiting qualified medical practitioners in safe facilities, they visit unscrupulous individuals in unsafe and unhygienic environments. Consequently, most of these women end up dying or developing severe complications that render them infertile or drastically reduce the quality of their lives. Each year, unsafe abortions lead to an estimated 70,000 maternal deaths and about five million disabilities in women (Ahman and Shah 1149). Legalizing abortion will ensure that all women have access to safe and legal mechanisms of securing abortions and thus reduce these deaths and disabilities.
Yet another reason to allow women to abort is to safeguard both their physical and psychological health. Sometimes, a woman may be in a position to carry the pregnancy to the full term. However, doing so may severely damage her physical and/or mental health. For instance, it is totally inhuman to force a woman who has been impregnated as a result of a rape incident to carry the pregnancy and deliver the rapist’s child. The woman should be allowed to terminate the pregnancy if she wishes to. Carrying the pregnancy and subsequently delivering the child can be traumatic and may have a huge psychological toll on her health. After all, she may neglect the child after birth or even abuse him because he is a constant reminder of the trauma the woman went through during the rape incident. The mother may not view the child as an innocent victim; rather, she may end up viewing him as a replica of the rapist. In the end, an innocent child ends up suffering for a crime that is not of his own making.
Another reason why abortion should be legalized is to reduce its prevalence. Statistics indicate that abortion is more prevalent in developing countries where laws are more conservative. In countries where laws are more liberal and abortion is legalized, fewer women resort to abortion. According to The Center for Bioethical Reform, “83% of all abortions are obtained in developing countries and 17% occur in developed countries” (Center for Bioethical Reform 3). Countries such as Netherlands, where abortion is legal on demand, have much lower rates of abortion than countries like Peru, where abortion is totally prohibited unless the mother’s life or health are in danger. A report by the Council of Europe’s Parliamentary Assembly Committee on Equal Opportunities for Women and Men titled Access to Safe and Legal Abortion in Europe concluded that “a ban on abortions does not result in fewer abortions, but mainly leads to clandestine abortions, which are more traumatic and more dangerous” (1). A 2007 study also showed that abortion rates were steeply declining in developed countries, where laws on abortion are flexible and are conducted safely, than in developing countries, where more than 50% of abortions are done unsafely (Sedgh, Henshaw, Singh, Åhman and Shah 1340).
One possible reason why abortion rates are higher in countries where the practice is banned by law is the fact that women in these countries do not get psychological guidance and counseling that forms part of the abortion procedure in countries that have legalized abortion. Before a doctor secures an abortion, he is obligated to inform his or her patient of all possible outcomes, as well as physical and psychological consequences of carrying on with the abortion. His or her client is also required to attend a counseling course. Some of these counseling courses have resulted in women changing their minds and deciding to carry the pregnancies to full term and delivering healthy babies. This would not be possible in situations where abortion is illegal.
It is also important to give women the right to choose the fate of their unborn child as well as giving them control of their bodies. When laws prohibit abortion, they effectively limit the woman’s freedom. A government or its laws should not exercise authority over such private issues as what happens in a woman’s womb. It should be left to the woman to decide whether to carry the pregnancy or not. Failure to give women this option breaches their fundamental human rights.

Compare and Contrast Reasons: Why am I for Abortion?
Though pro-life persons offer compelling arguments asking for abortion not to be legalized, their arguments are not as strong as those of pro-choice persons. Some of the reasons they offer are mainly based on strong convictions that are not backed up by facts. For instance, the argument that the Bible and other religious books have clearly banned abortion is true, but is simply based on a strong religious conviction that is not as important as reasons given by pro-choice supporters such as saving lives. After all, people have different religious convictions and the government and church should always be separate entities. The constitution and laws of the land should not force people to behave in a certain way in order to adhere to certain religious convictions. This will be a breach of their freedoms of worship and expression.
The argument that pro-choice supporters draw parallels to supporters of slavery is compelling. However, though there are lots of similarities, the two are very different. Slave owners were motivated by selfish interests. They used slaves to generate wealth and satisfy their own needs. They stood to lose greatly if slavery was to be abolished. The same does not apply to pro-life activists. They are neither motivated by selfish interests nor do they stand to gain personally from the legalization of abortion.
The argument that life starts before birth is also compelling but once again, it does not have a lot of strength. Arguments about when exactly life starts are not substantial and are better left to scientists. Defining when life starts only hold a theoretical value; it does not help to reduce the rates of abortion, neither does it stop the backstreet abortions that are dearly costing the lives of women.
Arguments by pro-choice supporters are very practical and strong. Rather than hold on to strong convictions that do not solve underlying problems, they give practical examples of the correlation between legalization of abortion and subsequent reduction in rates of abortion. They give women a better alternative. They do not urge women to abort; rather, they only ask that those women who choose to do so should not be caught and thrown in jails; they should be provided with necessary amenities for psychological counseling and if, after this counseling, they still wish to go ahead with the abortion, they should be allowed to do so in safe environments.

Ethical theories: Consequentialists?
Pro-life supporters hold on to absolutism while pro-choice supporters are more inclined to normative relativism. Whereas normative relativism asserts that all moral opinions are relative and that the morals of one person are not automatically equal to those of other people, absolutism holds that there are universal laws that should be followed without exception (“Ethical Theories” 1-2). The utilization of absolutism by pro-life supporters is evident in their quoting of the Bible and other religious teachings as absolute laws that human beings should abide by. It is also evident when they disregard figures showing that abortion is lower in regions where it is legalized and instead stick to what they believe should always be practiced universally; recognition of the notion that life starts at conception and no one has the right to terminate fetal life. This, according to them, is an absolute law that should be followed regardless of any evident benefits derived from legalizing abortion.
Pro-choice individuals also apply the principle of least harm and theory of utilitarianism more than pro-life arguers. According to a utilitarian, “the choice that yields the greatest benefit to the most people is the choice that is ethically correct” (Rainbow 13). For instance, legalizing abortion has been shown to reduce deaths of pregnant women. Though abortion may not be allowed in the Bible and other religious teachings, legalizing it leads to less harm and greater benefits as few women die and the rates of abortion are seen to plummet.
The consequences that will flow from applying theories aligned to pro-life supporters are disastrous to the society. If people do not evaluate the potential benefits associated with legalization of abortion and instead hold on to absolutism, the rates of abortion and deaths of young women will only increase.
There are different accounts of what is morally right. However I hold on to utilitarianism (doing what yields more benefits) and normative relativism as the best guidelines of what is morally important.

Summary of the Sources of Disagreement between Pro-Choice and Pro-Life Persons
The main source of disagreement between these two groups of individuals lies in the application of ethical theories. As described above, pro-life supporters hold on to absolutism while pro-choice supporters believe in normative relativism and totalitarianism.

Where is Abortion Legal and How Does it Work?
It is impossible to list abortion laws as they apply to all countries. This is because these laws vary from country to country. However, it is possible to come up with some general observations. For instance, in most countries, with the exception of Laos, Maldives, Vatican City, Belize, Dominican Republic, El Salvador, Nicaragua, Tuvalu, Chile and Uruguay, abortion is allowed to save a mother’s life (McManus 30). Abortion is legal on demand in most of the developed countries (McManus, 30). These include Norway, Sweden, Portugal, Netherlands, Spain, Switzerland, United Kingdom, France and Denmark (McManus 30). However, in some countries it can only be performed during certain stages of fetal development. For instance, it may be allowed during the first trimester and banned during the second trimester (McManus 31). Again, the definitions of these trimesters vary widely from country to country. In almost all countries where it is allowed on demand, there are strict procedures that medical practitioners have to adhere to before performing the operation on a woman. For instance, they must inform her of all the possible consequences and counsel her. They must ensure that the ultimate decision to terminate the pregnancy comes from the woman herself.

Vague Stories and Example
Horror stories abound about women who died or were partially or permanently disabled by abortions performed by unqualified personnel in unsafe environments.
Rosie Jiminez was a hardworking single mother of a 5-year-od daughter (“In Remembrance” 8). While still catering for her daughter, she got a scholarship to study education in a Texas college. However, just six months before successfully completing her studies, she became pregnant and sought an abortion. However, the Hyde Amendment had just been passed (“In Remembrance” 8). Among other things, this amendment stipulated that individuals who were being assisted by government could not receive Medicaid finances to support an abortion (In Remembrance” 8). Such individuals are the vulnerable in the society; they are too poor to afford paying for medical services from their own pockets. Rosie was such a woman. Unable to afford hefty fees charged by private clinics, she decided to consult an illegal abortionist. She died later after the operation went awry. This is not an isolated incident; there are several other sad stories about women who passed away or were maimed by illegal abortion operations.

Reasons for Supporting Abortion

In conclusion, I support abortion because of four main reasons:

(1) To save women’s lives
(2) To safeguard both their physical and psychological health
(3) To reduce the prevalence of abortion
(4) To give women freedom of choice


The government should endeavor to provide necessary abortion facilities to women who choose to abort.

Best Reason for and Against Abortion

The best reason for the support of abortion is to save women’s lives while the best for the opposition of abortion is to respect the right of life of unborn children.

Works Cited
Ahman E and Shah I. “Unsafe Abortion: Global Regional Incidence, Trends, Consequences, and Challenges.” Journal of Obstetrics and Gynecology Canada 31.12 (2009): 1149-1158. Print.
Alexander, Linda L., Judith Larosa, Helaine Bader, Susan Garfield and Williams Alexander J. New Dimensions in Women’s Health. Sudbury: Jones and Bartlett Publishers, 2010. Print.
Bryant, Richard D. Woodward and Gardner’s Obstetric Management and Nursing. Pennsylvania: Pennsylvania State University Press.
Center for Bioethical Reform. “Abortion Statistics.” CBR, n.d. Web. 01 May. 2011. <>.
“Ethical Theories.”, n.d. Web. 01 May. 2011. <>.
“In Remembrance: Women Who Died from Illegal and Unsafe Abortion.” National Organization for Women, n.d. Web. 01 May. 2011. <>.
Littleton, Lynna and Joan Engebretson. Maternal, Neonatal, and Women’s Health Nursing. Albany: Delmar Thompson Learning, Inc, 2002.
McManus, Joseph. Abortion: The Big Debate. Sebastopol: Lawrence Erlbaum Publishers, 2002. Print.
Parliamentary Assembly Committee on Equal Opportunities for Men and Women. “Access to Safe and Legal Abortion in Europe.” Council of Europe, 8 Apr. 2008. Web. 01 May. 2011. <>.
Cain, Miriam. “Prolife: 10 Arguments against Abortion.” Africa Christian Action, n.d. Web. 01 May. 2011. <>.
Rainbow, Catherine. “Descriptions of Ethical Theories and Principles.” Davidson College, 2002. Web. 01 May. 2011. <>.
Sedgh G., Henshaw S., Singh S., Åhman E. and Shah IH. Induced Abortion: Rates and Trends Worldwide. Lancet 370. (2007): 1338–1345.


Essay On Hospital Acquired Infections

Essay On Hospital Acquired Infections

Hospital Acquired Infections A hospital acquired infection is an infection that is acquired by a patient while receiving treatment in hospital. The patient was admitted in hospital for the treatment of a different disease however on being discharged it is discovered he has acquired an infection during his stay. These infections are known as nosocomial infections. Researchers released a report that stated that hospital acquired infections killed 48,000 people every year. Sepsis and Pneumonia were found to be the most common infections. The hospital discharge records of forty states were examined in the period 1998 and 2006 showing the infections cost $8 billion on treatment and lead to over 2 million days in hospitalization per year (Michael, Laxminarayan, Perencevich & Malani, 2010) The staff at the hospital may also be infected. The patients who mostly get the infections are those in acute care. There are several factors that have led to the rise in hospital infections such as the numerous varieties of medical procedures involving invasive techniques. In a research study carried out, hospital infections were on the rise in hospitalized children and adults waiting in hospital for surgery. Over 10.5 million medical records were examined and it was revealed that the bacterium, C-difficle was dangerously affecting the patients. The bacterium inflames the colon causing the patient to diarrhea. It also increased the risk of further hospitalization, surgery and death. The bacteria is also linked to the patients who overuse antibiotics and heartburn drugs (Nylund, Goudie, Garza, Fairbrother, Cohen, 2010). There is also decreased immunity against diseases among the patients. It is wrong when patients are prescribed for antibiotics yet they do not need them.

It is also not advisable for a patient to fail to finish an antibiotic prescribed dose. Both actions increase the rate of infection as it creates a breeding ground for the bacteria. It makes the bacteria resistant to further medication. In hospitals with poor infection control practices, the drug resistant infections are transmitted easily among patients. Other factors that increase the rate of infection are the number of patients that are malnourished or have injuries to the skin and the unhygienic environments hospitals. A study carried out in two hospitals, Montreal General and Royal Victoria, examined the rate of acquisition of hospital acquired acquisitions when patients are moved from a multiple bed to single bed room status. The study was carried out to verify the common held belief that single patient rooms provided higher protection against hospital infections. It was carried out in the intensive care units of the hospital. The results showed that the infection rate fell by 50% for the three hospital infections, Enterococcus, C-difficile and Staphylococcus in the patients who moved to single bed rooms. There was also a reduction of 10% in the duration of time a patient was admitted at the hospital. The study covered the period 2000 to 2005. It was further revealed that on average a case of C-difficile cost $7,000 per year in treatment. There are tremendous savings in using single-bed rooms (Teltsch, Hanley, Loo, Goldberg, Gursahaney & Buckeridge, 2011)
These nosocomial infections are found both in the developed and third world countries. There are people who die from these infections while others are affected in terms of restricted mobility leading to prolonged stay at the hospital.

These diseases may also affect the community when the patient is discharged leading to more sick people. Businesses are affected in terms of lost working hours. The treatment of these infections is a huge cost to the patients and the health institutions. The other common hospital infections are urinary tract infections, lower respiratory infections and infections of surgical wounds. The highest rate of infection is experienced in the intensive care units and the surgical wards. The resources that the hospital would have used for the treatment of serious diseases are used to treat infections that can be prevented. On preventing hospital infections all the people in the health profession need to be involved. There should be a regional or national program to assist hospitals to minimize the rate of infection. The objectives of the program should be identified and guidelines given to hospitals on health care surveillance and control practices. The hospitals should be monitored to see if the control practices being used are effective at all. There should be a yearly plan on how the hospital intends to minimize the rate of infection and monitoring tools be put in place. The senior management of the hospital should be fully involved in the initiative. They should establish an Infection Control Committee to oversee the control measures. Physicians and health professionals should be trained and given materials on hygiene. In the different departments in hospital such as nursing, laundry and housekeeping, there should be champions on hygiene. The policies and guidelines released by the infection committee should be looked at by management so that they can fully give their support. The infection committee should have the necessary authority to implement the infection Control policies (Ducel, Fabry & Nicole, 2002).

The management should also get involved in outbreak investigations. The hospital needs to evaluate its hygiene and safety policies and procedures and measure its adequacy in preventing hospital infections. Environmental cleanliness should be maintained at all times. In the food department the director of the catering department should ensure that there are guidelines in the purchase of foodstuffs and that hygiene is observed in the kitchen. The equipment and the storage areas should be kept clean. There should be policies and instructions issued to the catering staff on hand washing and disinfection processes. The methods used by the hospital in the preparation and distribution of food should also be hygienic. The staff should go through training on food safety. The methods used by the staff in disposing wastes should be appropriate. The laundry department should ensure the beddings and clothes are changed frequently. The dirty linen should be disinfected appropriately. When the laundry is being transported from the laundry room to the wards the staff should ensure there is no contamination. The housekeeping department should ensure that all the rooms are cleaned appropriately. Washing items such as soaps should be replenished regularly. The pest control services in the hospital should be at the optimum level. There is the prevention of patient to patient infections through washing hands, using gloves, isolation and other sterilization practices. The physicians and nurses need to be even more diligent as they have the most contact with the patients. The physicians have a role to provide patient care in a way that minimizes infection. They should be more careful when performing invasive procedures. The invasive procedures should be minimized and other procedures used where possible.

They should ensure they wash their hands and use sterilized equipment. Furthermore the physicians should serve and even support the Infection Control Board. All cases of infection should be notified to the board and the hospital management for control purposes. The physician should advise patients and visitors on the importance of hygiene. The nurse should also observe hygiene and report any evidence of infection immediately to the physician. The patient should be isolated to prevent infection of other patients, staff or visitors.
In a research carried out in hospitals, it was found out that when there is an outbreak of hospital infections, contaminated hands are often the medium used in transmitting the infections (Larson, 1988). It was revealed that when a hospital ensures decontamination of hands the rate of infection is drastically reduced.The hands should be washed depending on the frequency of contact with patients and the type of health care the physician is providing to the patients. For hand washing the patients and staff should use running water and anti-septic soaps. The towels used to dry the hands should be clean and preferably disposable. There should be training on hand washing so that people know the correct way to wash hands. Most people never remove rings or bracelets when washing their hands. The hand and the forearm may need to be washed in some instances. There should be safe infection practices practiced. The physicians should avoid and eliminate unnecessary injections. There should be no rush at all to inject the patients. The needles and the syringes that are used should be sterile and preferably disposable. The disposal of the injections should also be carried out appropriately.

The physicians and nursing staff should wear gloves for their own protection. Sterile gloves should be worn during surgery and other invasive procedures. The hands should be washed once someone stops using the gloves. The gloves that are disposable should not be reused by staff. The staff to ensure they always wear masks in the operating rooms or when handling patients with airborne diseases. The patients with airborne diseases should also wear masks when venturing outside their rooms. In terms of clothing for the health professionals, the material should be easy to clean and sterilize. If the staff is exposed to blood or any other kind of discharge the uniform should also be changed. The shoes that are worn by the staff should not be worn anywhere else. They should also be fairly easy to clean. The patients should have good nutrition and be vaccinated appropriately.
The patient equipment should be disinfected and sterilized appropriately. The hospital should be controlling the outbreaks and monitoring the rates of infections to see if there is any improvement. The hospital will be better prepared to handle it where there is early identification of the outbreak. There should be investigations carried out to find out the causes of the infection and control measures put in place. The patients with the infections may need to be isolated. An outbreak occurs when there is an unexpected increase in the rate of infections.
As mentioned in the prevention practices, these are infections whose transmission and infection can be drastically prevented both in the developed and developing countries simply by observing hygiene and cleanliness. The prevention of hospital acquired infections requires all the people involved to work together to contain the infection. Any department in the hospital that does not perform its role provides a break in the chain leading to chaos.

Ducel, G., Fabry, J. & Nicole, L. (2002). Prevention of Hospital-Acquired Infections.
Retrieved from:
Larson, E. (1988). Cause Link between Hand Washing and Risk of Infection? Examination
of the evidence. Infect Control Hosp Epidemiol, Vol. 9, 28–36.
Michael, R., Laxminarayan, R., Perencevich, E. & Malani, A. (2010). Clinical and
Economic Outcomes Attributable to Health Care–Associated Sepsis and Pneumonia
Archives of Internal Medecine, Vol 170(4), 347-353.


Sample Admission Essay On Why I Am A Good Candidate For The Nursing Program At Massasoit Community College

Sample Admission Essay On Why I Am A Good Candidate For The Nursing Program At Massasoit Community College

Nursing is a lifelong commitment to caring for ill and incapacitated, responsibility, and learning. A good nurse must be able to care for patients in an empathetic manner, while at the same time maintaining an appropriate distance in order to conserve the qualities necessary for the suitable care of the next patient. A nurse must be dedicated to their profession, and exhibit great stamina in order to endure long and demanding hours. Additionally, exemplary communication skills are necessary in order to effectively report on the patient’s condition to other members of the healthcare providing team, and to connect and educate the patient and their family regarding suitable care. A good nurse must be attentive to details, well organized, and willing to learn.
My experiences with patient care began with taking care of my terminally ill grandmother. My grandmother suffered from brain cancer and needed a caretaker, one that was willing to take care of her in her home where she felt the most comfortable. Despite having young children of my own, I took on this challenge as a result of respect and dedication to her. Providing hospice care is never easy, much less so at a home without the full array of equipment that can be found in an actual hospice or hospital setting. In the clinical settings, the patient care is standardized and regimented so that members of the healthcare team provide the services that they provide best. Physicians make their diagnoses and prescribe medications, nurses provide attentive care and support to the patients, and orderlies change sheets and clean the patient’s rooms regularly. However, at my grandmother’s home, I was responsible for coordinating the activities beyond my capacity, and performing the bulk of the substantive work involving her care. While the care I provided was trying, and at times tested my patience, I take solace in the fact that it was a rewarding experience that brought me closer to my grandmother and provided her with love and dedication in her final days.
Dedication to education is an important quality in any healthcare provider. Practitioners must be willing to learn from their mistakes and throw out centuries of dogma when science discovers a better way to heal people. Furthermore, it is important to be able to transmit this knowledge to future generations of clinicians in order to advance the learning further, and to provide the highest possible levels of patient care. In my Licensed Practical Nurse course, I have always strived to achieve academic excellence in order to provide me with the foundation necessary to be a good practitioner. My dedication and team spirit enabled me to be placed on the Dean’s List last semester, and to graduate third in my class. The accolades of my family for my achievements was appreciated, but the most satisfying part of the experience was knowing that I had dedicated and tried myself for the sake of my future patients.
As the mother of three children, I understand caring for people. My experiences with my grandmother opened my eyes to the necessity of compassionate and empathetic end of life care. My ultimate goal is to work at the Daner Farber Cancer Institute in Boston, in order to provide high quality nursing to suffering people. Massasoit Community College’s excellent reputation and dedication to students’ success will be of critical benefit on the long journey towards becoming a successful nurse practitioner.


Good Thinking As A Nurse Book Review Example

Good Thinking As A Nurse Book Review Example

Summary- Thinking as a Nurse
Summary- Thinking as a Nurse
Bruce Austin Scott completed his B.S.N and M.S.N at University of Alabama in Huntsville and University of Texas in Austin respectively. He has over twenty-five years of teaching experience and over thirty-seven years’ experience of patient care. Before writing this book, Bruce Austin has written many articles for famous publications as well. All these statements prove Bruce’s expertise and wisdom. He has all the necessary skills, information, experience, and knowledge required to write a book.
Evaluating the expertise of an author is one of the most appropriate ways to judge the book content. A book written by a knowledgeable and experienced author of the respective profession will contain nothing but truth. One can blindly trust its content and look forward to it in any phase of life. Therefore, the book “Thinking as a Nurse” is also a reliable book containing authentic information.
The book includes all the technical and non-technical factors of nursing, i.e. cerebral, and cognitive aspects. The main objective of Bruce was to enable readers identify a patient’s problem and find its appropriate solution. Most importantly, he aimed to deliver his knowledge about characteristics of nursing, distraction of technical skills, and impediment of memorization to his readers . Some of the topics discussed in the book include empathy, nurse-physician relationships, and pathophysiology .
Bruce succeeds in achieving his goal, as the readers especially students gain a lot of knowledge about clinical practices. They learnt how to communicate effectively with their patients by listening to their problems and understanding it clearly. In this way, the book also accomplishes its goal of sharing knowledge.
Bruce has used examples from real life to emphasize on his point. He also shares his experiences and relates it to the topic so that the concept is clear to readers. For instance in his chapter about “Professionalism, a way of life”, Bruce tells about an interview which he asks from most of the students. He says he always asks the students why they want to be nurse. Of all the different answers, the most disappointing one was becoming a nurse for fun . Here, Bruce tries to change the mind of such students by emphasizing the importance of professionalism and seriousness in nursing. The patients look forward to nurses and they should never consider their profession a means of fun. In fact, nurses should devote their lives for patient care.
The books include all the important topics covered. However, the book is very short, and the author could not explain each of its topics in great depth. Some topics like pathophysiology should have been discussed in detail so that the novice member to this profession could also understand it very easily. In this way, by adding few more pages to the book, Bruce could have made his points more clear. Moreover, the inclusion of some pictures and illustrated examples could have been a better approach.
In my opinion, there is no topic that is left out in the book. However, I did mention some details are missing but the entire topic is not. As the book only aims to deliver knowledge to at basic level, I believe the topics covered are enough. While reading the chapter about smartness of teamwork, I could constantly link my practical life with it. I realized the importance working as a team in this profession.

Scott, B. A. (2009). Thinking as a Nurse. Bloomington: iUniverse.


Free Adolescent Condom Use Research Paper Sample

Free Adolescent Condom Use Research Paper Sample

Protection of Human Participants
The participants of the research were sexually active girls aged between 13-17 years. The research was a clinic-based study and participants were able to various benefits of enrolling in the study. The participant could be enrolled in a youth development program; they were able to enjoy various services offered in the program. They were engaged in peer leadership programs and involved in a service-learning program for 18 months. The participants were briefed on what the study would involve since there were no serious risks involved in the research; it was a research based on free will from the participants. Participants had to go through a trial referred as the Prime Time; 1434 girls participated in the trial; 571 were eligible form the research and 253 girls agreed to participate in the research after provided their written consent. The institutional review boards of the University of Minnesota and the clinics involved in the research approved the study and protocols involved. The participants involved voluntarily since it is not all the participants who were eligible for the study were selected; it is only those who had willingly agreed that were selected. Since most of the girls were minors, their parents and guardians were involved in seeking consent.

Data Collection
The research focused on two measures that determine consistency in condom use, these measures are global and collaborate specific which form part of the independent research variables. There were various dependent variables within the research such of research participants and sex partners among the research participants. The researchers have, however, not clarified on the key dependent and independent variables, however, after going through the research paper one gets to understand the variables involved. The data collection method started with the Prime Time trail where the participants were selected from a given sample. After the participants were all selected, baseline data was collected using A-CASI methods after which girls were randomized into different study conditions. During the baseline and 6-12 months of the research period the girl answered surveys questions about contraceptive use and sexual behavior; this was a systematic method of data collection in the research. Use of surveys ensured that participants were able to provide research information at different stages in the research and to analyses, the consistency of the information provided. After 12 months, those who had met the criteria proceeded to the next research stage, which took six months. Data was fully collected through answering questions which were on the A-CASI.Since most of the information collected was private, researchers assured participants of their privacy and sometimes they were compelled to carry the research in a private place. The questions were asked on a face-to-face basis; therefore, any clarification that needed to be made was easily made. Face to face, interviews offer an advantage in terms of correction of any emerging errors than other methods such as questionnaires. Control instruments were used in the interviews and questionnaires, when the participants were being asked about global condom use consistency, they were provided with five answers’ participant was supposed to select an answer from the five responses provided. The responses ensured that any information that the participants provided was relevant to the research; this is important in eliminating errors and irrelevant information. For partner specific condom use consistency, there were four responses provided .It was easily to compare the two research variables based on the responses given.

Data Management and Analysis
The research was based trajectory groups, in analyzing the data provided; statistical modeling and subjective classification rules were the key methods that were applicable in this case. The researchers used subjective classification rules since the research sample was small, and there were only three points for analyzing the change. Trajectory groups were then formed based on the measures reported on consistency of condom use. All participants were categorized into five trajectory groups; one was use to represent condom use while zero represent lack of condom use. Tabulation was presented on the table depending on the distribution of participants. The analysis was then represented on the final analytic, which was a comparison of global condom use versus partner specific use. Pearson’s chi-square was used in cross tabulating the data while final analysis was done using SPSS program. There was no comparison of the research findings since there was no previous research that would have been used.

The findings show the comparison between global and collaborate specific condom use. In each of the trajectory, there was information provided on girls who used condoms and those who did not use them and relationship it has with the baseline information. The findings are a reflection of the society; there are various factors that determine condom use among sexual partners. Nurses can use this information especially during civic education programs and also when addressing ways or reducing transmission of sexually transmitted diseases .There were various limitations in the research such as a research sample; a bigger research sample would have made the results more feasible. The researchers have also provided reference material that is useful for future research as well as analyzing this research (Burns & Grove, 2011).
Nursing Research. Adolescent Condom Use Consistency Over Time: Global Versus P :. Retrieved April 4, 2014, from
Burns, N., Grove, S. K., & Gray, J. (2011). Understanding nursing research: building an evidence-based practice (5th ed.). Maryland Heights, MO: Elsevier/Saunders.
Polit, D. F. (2010). Statistics and data analysis for nursing research (2nd ed.). Boston: Pearson.
Work Cited


Epidemiology Of Lung Cancer Essay Example

Epidemiology Of Lung Cancer Essay Example

Lung cancer is a deadly disease that jeopardizes health of people globally. Diagnosis of this disease has made it difficult to be prevented or treated since no single test has been found to diagnose lung cancer accurately. Hence, series of tests have been implemented to test for this disease. The diagnosis of the disease has enabled doctors to come up with some specific and accurate preventive measures that have been put in place to reduce the incidences of this disease. The section of this paper will therefore discuss laboratory measures and diagnosis of lung cancer, useful tumors of cancer diagnosis and some preventive measures that are implemented to reduce the incidence of lung cancer.
Although no single test has been found to diagnose cancer, several methods have been put in the laboratory to identify this disease. First is chest x-ray. This is the first line of diagnosis of lung cancer whenever there are convincing lung cancer symptoms. The procedure of chest x-ray involves view of back, front and sides of the chest(Held & Schiech, 2014). Although this method cannot determine lung cancer, evidence of hamartomas is in the chest may mimic the present of lung cancer. Second is computerized tomography (CT). This is the scan that might be ordered when x-ray shows no abnormality in the cells. It combines use of multiple images at different angles of the body. It is more sensitive than x-ray since it shows more nodules of the chest.
Another common laboratory diagnosis is sputum cytology. The diagnosis of this disease often requires identification of malignant cells. The sputum examination allows the identification of tumor cells under the microscope for diagnosis. This is the known risk free and inexpensive measure of diagnosis. It has one disadvantage: the tumor cells may always not be present in sputum even when cancer is present. Fourth is bronchoscopy. This is the examination of the airways through fiber optic probe that is inserted through the mouth or the nose (McCarthy & Jeon, 2012). Lung cell tumor in the central airways is thoroughly examined for cancer cells. This is risky and must be done by a pulmonologist.
Blood test is also commonly used to examine lung cancer. This one alone cannot diagnose cancer but it can reveal metabolic and biochemical abnormalities associated with cancer. For example metastatic cancer can be accompanied by certain level of calcium or alkaline phosphate enzyme; this is a hint for cancer and gives chance for further testing (Held & Schiech, 2014). Likewise, present of aminotransferase and alanine aminotransferase signals lung damage through metastatic tumor.() says that, biomarkers or specific proteins in blood signalize present of cancer in the lungs. A complete blood count (CBC) determines number, size, and maturity of blood cells. The abnormal occurrence of number of blood cells indicates an infection. Hence, regular blood checkup is necessary for lung cancer diagnosis.
Needle biopsy is also a major method of lung cancer diagnosis. It may be used in retrieving cells from tumor nodules that occur in the lungs. This useful particularly when the tumor is located in the peripheral region and cannot be accessed by bronchoscopy (Fawcett & Rynas, 2012). Lastly is thoracentecis: in some cases the lung cancer may be in pleural lining of the lungs and can lie between the chest wall and the lungs. This involves aspiration of this region for further diagnosis. Risk of pneumothorax may be involved in this procedure.
There are several markers of lung cancer; first is neuron specific enolase (NSE). It has no sensitivity required for screening but it has been supported by numerous studies in diagnosis. High amount of serum with suspicion of malignancy indicates the presence of small cell lung cancer. Likewise, patients have been found with moderate NSE in the lungs as colorectal, gastric and breast cancer. Second is carcinoembryonic antigen (CEA). Its concentration is particularly very high in adenocarcinoma and lung cancer, but elevated concentrations is also found in various benign and some malignancies preclude its use in screening and limit its diagnostic use (Zakowski, 2013). However, it may be useful in the differential diagnosis of non-large cell lung cancer. It may give prognostic information particularly in cases of adenocarcinoma found in the lungs. CEA also has a role in monitoring therapy stages and also detecting non-small cell adenocarcinoma.
Another important lung cancer marker is squamous cell carcinoma antigen (SCCA). It is also less sensitive but it has superior sensitivity for squamous cancer of the cell hence is used in histological subtyping. It can be used significantly in the diagnosis of non-small cell lung cancer in combination with CEA. Progastrin-releasing peptide (ProGRP) is another lung cancer marker for small cell lung cancer, with good specificity and sensitivity (Luo et al.), although in view of the incidence of small cell lung cancer in the general population these are not high enough to allow its use in screening.
There are several ways of reducing the incidence of lung cancer. First is minimizing use of tobacco. Tobacco is the main cause of lung cancer worldwide estimated to be 22% of cancer death per year (Murugan et al.). Tobacco smoking may cause many types of cancer such as esophagus, larynx and even mouth. When consumption of too much tobacco is stopped, the incidence of lung cancer can really go down worldwide. Second is observation of diet and exercise. Dietary is very important in lung cancer control. Excess consumption of red meat may be associated with the risk of contracting lung cancer (Murugan et al.). Hence, good eating habits are also factors in lung cancer incidence reduction. On the same note, exercise ensures a healthy body with no or little diseases.
Environmental pollution also accounts for 4% of all cancer including lung cancer. Highly pollute area should be avoided since they contain carcinogenic compounds that can find themselves in the body through water drinking or in haling. Ionizing radiation has been long time researched to be the source of lung cancer. This is evidenced by Japan A-bomb survivors who were found to have several types of cancers. Avoiding such areas reduces cancer incidence
Lastly, risk factor of lung cancer increases with the increase of alcohol consumption. For example, 22% of mouth and lung cancer was noted in people taking alcohol in a research done in a university in Nigeria (Murugan et al.). This suggests that reduction in alcohol consumption will reduce prevalence of lung cancer.

Fawcett T., & Rynas, S. (2012). Taking a patient history: the role of the nurse. Nursing Standard, 26(24), 41-46.
Held J., & Schiech, L. (2014). Non-small cell lung cancer. Nursing, 44(2) 32-43
Luo J., Chen, Y., Narsavage, G. L., & Ducatman, A . (2012). Predictors Of Survival In Patients With Non-Small Cell Lung Cancer. Oncology Nursing.
McCarthy, w.. & Jeon, J. (2012). Chapter 6: Lung Cancer In Never Smokers: Epidemiology And Risk Prediction Models. Risk Analysis. An International Journal.
Murugan, p., Stevenson, M. E., & Hassell, L.A. (2014) Performance Validation in Anatomic Pathology. Archives Of Pathology & Laboratory. 138(1), 105-109
Zakowski, M. F. (2013). Lung cancer in the era of targeted therapy. Archives Of Pathology & Laboratory 137(12)1816-1821


Example Of Overview Of The Healthcare Organization: Maxim Healthcare Services Report

Example Of Overview Of The Healthcare Organization: Maxim Healthcare Services Report

Final Project
The Maxim Healthcare Services are a United States based healthcare provider with a presence in more than forty states in the country. The paper would concentrate on the branch located in Indianapolis, Indiana. The organization offers healthcare services and in that vein employs thousands of staff including nurses of various qualifications and leaning such as Registered Nurses, Licenses Practical Nurse, Certified Nurse Assistant, among others. It is imperative to note that the organization has diverse healthcare facilities and arrangement with nurses being employed in the following service departments: homecare nursing, travel nursing, emergency nursing, internal clinical services, among others.
The work arrangement is flexible and depends on the contract provisions between the employer and the employee. On the overall, Maxim Healthcare Services are an organization informed by the need to provide healthcare services to the citizenry in America. It is noteworthy that the organization operates under the free enterprise system in the United States of America. However, its main objective is the provision of healthcare to the citizenry and not merely to earn profits.

Overview of the job position and reason for selection
The emergency nurse is a qualified registered nurse, abbreviated as ER Nurse RN. This position plays a critical role in three main departments, these are, the intensive care unit, the critical care unit and the medical surgery. The job position confers essential roles to the nurse in the mentioned departments. The main roles include: planning, implementing and evaluating patient care, assessment of signs and symptoms indicative of the patient’s condition, performs interventions and remedial actions in response to priorities in the work place in consonance to the hospital policy and the patient care outcomes and conditions, ensures patient care needs are fully addressed and that patient comfort ability is maintained to the best interest of the organization, ensures implementation of the doctors’ recommendation and advise including interpretation and administration of the diagnosis and prescription from the doctor, among other auxiliary duties. In appreciation of the roles of the emergency nurse, it is essential to elaborate on the essential position that the emergency nurse plays in the work environment. The nurse is there to provide continuity in the medication process. The doctors diagnose illnesses and prescribe medication while the nurses are left to care, evaluate and monitor the patient’s progress and condition.
This job position was selected for its essential role in the overall treatment, recuperation and monitoring of the patient. It illustrates the special role that nurses play in the administration of healthcare services. It negates the stereotype that nurses’ roles are often merely auxiliary. It puts into perspective the contribution of nurses and especially in the emergency department hence my motivation to cover and analyse it.

Job position in the organizational hierarchy
In the healthcare industry and specifically the hospital setting, the hierarchy is often flatter entertaining only three main levels or job groups, these are, the management, the skilled personnel and the semi-skilled personnel. All healthcare professionals involved in the active discharge of medical services fall in the second hierarchy. The nurses hence fall in the skilled personnel category. In this hierarchy, the nurses fall below the doctors. A keen evaluation of the hierarchy places emergency nurses under the doctors and physicians and in the same level as other nurses.

Challenges in recruitment and retention and the importance of the job position
It should be noted that emergency nurses do not have a definite time of service. However, as is the case in the Maxim Healthcare Services, emergency nurses work on rotational basis. They serve in the various mentioned department on a shift often of eight hours. In addition, the nurses work in teams. For instance, team A of ten nurses could man critical unit B for eight hours and then exit to allow team B to proceed for another eight hours. The challenges often arise in the risks and inconveniences experienced. Cases of night shifts, exposure to blood borne pathogens and toxic and chemotherapeutic chemicals increase the risks inherent in this profession. Generally the turnover is low. Nurses are often committed to their work and would seek alternative solutions other than quitting. Some of teetering challenges the organization often grapples with in relation to retention is the shift programming, the salaries and allowances, continued training and the annual and maternity leave programs. Recruitment programs are often handled through intense interviews with the pooled recruits being a blend of experienced and fresh graduates. The training and orientation often presents challenges especially for fresh graduates primarily because of the expectation gap from the college experience to real workplace environment. However, on the average, the recruitment and retention is often handled effectively through the human resource department.
The importance of the job position lies in the fact that these personnel provide continuity in medication processes. They evaluate, implement and regulate the medication process as prescribed and instructed by the doctors. Their role is essential in the overall administration of healthcare services especially given the critical conditions in the emergency set ups.

Interesting Aspects
Some of the striking aspects that I liked in this job position was the organization places on emergency nurses. In appreciation of their critical roles, the organization ensures all their employment grievances are listened to and addressed. In addition, the nurses’ remuneration is subject to a progressive review each year, as at 2012, the average annual income in Indiana was $64000.