Nurse Work Force Violence : Mileu Conciderations and Risk Assessment

Mileu  evaluation were performed during the 1990's by Interior Decorators  in hospital settings to establish and increase patient comfort levels ; during such evaluation issues that decrease patient comfort were identified ; and suggestions that include principles of Interior Design  were implemented to increase patient comfort . Among some of the suggestions implemented were Funcshu to add a comfort level that is becoming to patients , how ever , this is no longer the 1990,s . Nurses across America are  quickly coming to terms with the fact that Work Place Violence is an all to real hazard perhaps because the premise that a hospital mileu are in truth a setting were multiple crisis are addressed   completely escaped the interior designers during the 1990,s.  Statistics related  to Hospital personnel violence;  particularly Nursing Staff are on the rise . Health Care workers in private industries reported non fatal work place violence injuries in 2013 that was more than 67% of the total number in all industries (NIOSH,2017) , although the health care industry employed only 11.5% of all the U.S work force . Many health care workers do not receive  formal training in work place violence prevention and still face assault risks while working close to people n tense and often stressful situations (CDC,2017).

Identifying Aggressive Behavior in Health Care Settings
Identifying aggressive behavior in health care settings includes : Assessment and Tact , for example one of the first signs of aggressive conduct is pacing ; a person who has become agitated tends to pace around the person who has become a target for the dissemination of an aggressive event . Other behavior include lewd and disrespectful comments , heavy breathing , and perceptual disturbances . The hospital setting are not the sole proprieter' s of this epidemic . Nurse who work from such settings as ; 1) Visiting Nurse Services , 2) School Nurse Settings , and 3) Community Health Nurses as well as Nurse Researchers  are at risk for suffering violent attacks .
Nurse researchers have often been confused by people ;when working from a community as social service workers whose aim is to evaluate issues that pertain to social services . This can also be true when engaging in Trans national research settings . For this reason limiting work force violence training to the hospital setting is not effective because nurses work in very distinct and diverse setting   New guidelines need to be in place and think tank are recommended that includes ANA , ICN , and NIOSH to establish laws that are Universal and provide protection from work place violence that include, ergonomics, infrastructure , and aggressor punishment and civil damage attainment .

Reeences

CDC(2017) NIOSH Sector and Cross Sector Program Supplement 2006- 2017 . Retrieved from http///www.cdc.gov/niosh/docs/2017-147/pdf/2017-147.pdf           

     

Mononucleosis : Is this the cause of ALS and MS ?

Prediction to susceptibility of the condition Multiple Sclerosis may have significant clinical applications ,either as part of a diagnostic algorythem or as a means to identify high risk individuals for prospective studies (De Jager et al 2018) .While this becomes the desire of a researcher ; two outstanding factors related to assessing risk and to clinical assessment have  recently been scientifically elucidated that may change the way I which MS or Multiple Sclerosis are both diagnosd and treated in the near future  The first overarching factor hat changes the way I which clinicians approach a patient at risk for MS is that Mononucleosis has been recently tied to the development of Multiple Sclerosis . Mononucleosis is a communicable infection hat harbors in the lymphatic system and which affects the nervous  system ; this infection has also ben linked to Epstein Barr Virus which also affects the nervous system and causes paralysis. The second overarching factor and perhaps the most relevant is the many clinicians argue the Multiple sclerosis is not a genetic disease ; while scientists argue that it is . Recently the following research were established using CRISPR a promising gene editing tool which may soon be utilized to treat Multiple Sclerosis    First lets define exactly what CRISPR is , CRISPR Cas9 defined as Clustered Regularly Interspaced Short Palindromic Repeats is a gene editing modality that was discovered while examining the activity and behavior of microorganisms , their infectious process and the way in which viruses contaminate healthy cells . In order to understand the relationship that Epstein Barr and Multiple Sclerosis h              have with the disease manifestation we must remember that Mononucleosis is a virus and that quite possibly it might also be responsible for the development of MS ;because its link to Epstein Barr has already been noted . This must be taken into concideration when assessment of paralysis like conditions are being evaluated . So when we examine the premise that Multiple sclerosis is not a  genetic condition we produce the following data : Multiple Sclerosis is a cell mediated autoimmune response which means that the cells respond in a way that does allow for the recognition of cells as proper ;but are being recognized as foreign to the body . The only scientific reasoning for this confusion are invasion of virus which causes such immune response as seen with Epstein Barr and which are likely in MS aswell.  ALS which are a similar disease to MS and which  are also similar to Epstein bar in their ability to cause paralysis . CRISPR CAS9 technology establishes the following with regards to ALS or Amytrophic Lateral Sclerosis : Hexanucleotide repeat expantion in the C90RF72 gene are the most common cause of amytrophic lateral sclerosis and frontotemporal dementia (Nature Genetics ,2018) C9ALS/FTD . The nucleotide -repeat (DPR) proteins , which are aggregation prone and may contribute to neurodegeneration of the myelin sheeth which lines the nerves . CRISPR Cas9 would there for serve to answer questions related to weather MS is genetic in nature and or communicable .

Refernces
doi: 10.1038/s41588-018-0070-7
O Cooner,P (2008) Multiple Sclerosis :Everything You Need to Know .Firefly Publishing New York USA                    

ADHD Mimicry in disease : Child developmenta lStages to aid in correct diagnosis.

The official diagnosis criteria  for ADHD can be found in the DSM-IV . The criteria states that the individual must exhibit six or more symptoms in the attention category, and or six   out of nine symptoms from the hyperactivity and impulsivity criteria . When these are present within a six month period they are evaluated and tallied to comprise a diagnosis ; which is usually followed by a plan in rehabilitative and prevention strategies that concider cognition and learning difficulties . While this present diagnostic criteria is standard in the DSM-IV it maybe different and distinct within settings, jurisdiction  , (present)  clinical case or acculturation abilities. The following are four diagnostic criteria from the Inattention part of the diagnostic fame 1) often has difficulty sustaining attention to task or play activities ,2) often has difficulties organizing tasks and activities, 3) often avoids dislikes or is reluctant to engage in tasks or activities , 4) is often forgetful in daily activities or easily distracted by extreneous stimuli (Reif, 2004)  Two of the diagnostic criteria from the impulsivity portion were selected to draw differences from  Metabolic disorders that often mimic ADHA and which are difficult to diagnose in children ; these are as follows 1) is often on the go or often acts as I driven by a motor , 2) often has difficulty playing or engaging in leisure activities quietly. A few of the  defining characteristics in symptom measure post evaluation have ben chosen to allow further scrutiny in differentiating metabolic disease fro ADHA ; these , are as follows ; first the symptoms must be maladaptive and inconsistant with the individuals developmental level and second the symptoms are not better accounted for by another mental disorder . ADHA is a neuro-biological disorder ; but so are many other metabolic disease which if not attended to can not only mimic a diagnosis of ADHA but might hinder adequate treatment . Lets begin the analysis by stating that both ADHA and for instance a metabolic disorder such as Hypothyroidism are similar in symptomotology where it pertains to psychosocial development; how is this possible when one disease is biological and the other is psychosocial . Hormone regulation are very much a silent player in child development and a factor that is often lost in the diagnostic equation ;particularly if external factors are also at play, such as the ones sated above . The most relevant issue is that hormone regulation or dis-regulation can even disturb Libel, affect, demeanor and memory retention in the afflicted child which mimics some of the diagnostic criteria found in the inattention portion  or the ADHD criteria as well as many other disease manifestations ; for this reason rigorous evaluation and clinical testing over an 18 to 24 month period should be performed because hormone dysregulation can have its affect upon the child while testing can bet false negative .This dynamic can also be observed in lead poisoning and testing ; to name just one other psychosocial health condition, the only difference is that lead poisoning are subject to exposure but the overarching determinant  in diagnosis in both ADHA and lead poisoning are time frame and presence of alterations in behavior due to a silent irritant ; lead and hormone did-function.

References

Reif, S( 2004) T he ADHA Book of Lists: A Practical Guide for Helping Children and Teens with Attention Deficit Disorder     . Wiley Publishings .