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 .  

Is Oxidative Stress the Causality in the Develoment o HIV Virus

Most physicians believed that stress only lead to the development of a peptic ulcer; this is classic post positivistic scientific view. Ulcers are caused by H Pilori ; a gastrointestinal bacteria found in the stomach which is treatable with antibiotic treatment, how ever ,stress has the ability to cause non essential organ system disease (Zopolsky 2018) how does this occure? This occurs because when the individual is in the midst of a stressful event his or her primary physiologic function are the fight or flight response . This response is important to combat the stressful event in which the individual finds himself or herself ;and is guided by the sympathetic nervous system   meaning that essential systems such as the immune system are placed in the back burner while the stressful event is resolved . But what happens when stressers become multiplied ? , the immune system never really reactivates itself and  if it does; its not for long. This causes oxidative stress ; which is a very different type of stress, this type of stress uses distinct mechanisms of recovery and has the ability to cause devastating physiologic damage.  Some of the following pathologies and disease development associated with oxidative stress are  (1) heart failure (2) peptic ulcers (3) hair loss (4) cancer (5) obesity (6) mental illness , and (7) cell death. Is oxidative stress a factor in placing the individual in prime susceptibility for contracting HIV ? . Yes , because when  oxidative stress begin to occure cells lose an electron ; but to survive it retreaves an electron to replace the lose . If oxidative stress is in process and has no mechanism or electron supply to retrieve from then there is cell death . What can cause oxidative stress? Some of the following factors that cause oxidative stress are poor nutrition , ilicit drug use, IV rug use , illness , poverty and social stress . When these factors  occur alone they are not sufficient to cause oxidative stress which in turn cause cell death; however when these factors are almost all present in the life of an individual they do have the capacity to cause oxidative stress. that in turn cause place the person in a prime condition to contract HIV virus . Such as seen in an IV drug user who may have poor nutrition and homelessness , or a homosexual man with family issues who also uses drugs and suffers sexual repression. These examples are a few of the multiple which prevent the immune system to both function , prevent disease onset and  ever recovering its full function; because it is constantly being placed in the back burner .  To combat this type of stress antioxidants are necessary because they strengthen the cell from which electrons can be pulled when oxidative stress attempt to occur there by preventing the process of or onset of oxidative stress. Antioxidants are obtainable from fruits ,vegetables , supplements such as green tea.



References

Sapolsky , R (2017) The Science of Stress . Portrait of a Killer. National Geographics

E.J Corey , Czako , B & Kurti , L (207) Molecules and Medicine . Wiley Publishing              

HIV Viral Expression

While field epidemiology  of acute problems share many characteristics with prospectively planned epidemiologic studies ; they may differ in at least three important  aspects , first because field investigations often start  without clear hypothesis they may require the use of descriptive studies to generate hypothesis before analytic studies can be defined and designed and conducted to test these hypothesis , second ; as noted previously ; when acute problems occur there is an immediate need to protect the communitys health and address its concerns. These responsabilities drive the epidemiologic field investigation beyond the confines of data collection and analysis and action  Gregg,M ( 2004). Finally , field epidemiology requires one primary narrative to concider when the data are sufficient to take action rather than ask what additional questions might be answered.

Why is this significant? because this epidemiologic investigative sequence  serves to analyze the operational methodology of the epidemiolgic investigation that lead to the diagnosis of HIV during the 1980s and whether  biological plausability where applied .

A retrospective analysis only raises more questions; one of which is ?where lifestyles a contributing factor in developing HIV virus  contributing factor and yet another question might be :is oxidative stressa contributing factor as well. Last weeks post recommended using homeopathic nterventions as complimentary medicine when rating HIV and AIDS . Another factor to concider is , ? are gene expression a  factor in phenotype development and did scientists foresee the constant mutation of this virus which were never appropriately isolated to begin with . The virus existance rest on particulate matter which hon ad been exposed o a supernatum or growth factor . The controversy surrounding the condition is not the syndrom or AIDS but rather the test sensitivity and specificity which relies upn antibodys formed from the presence of a virus which a person had been exposed to . In additin when we analyze the behavior associated with life styles of a living organism exposed to the virus ; we forget that a single organism has a behavior as well that al?low for the identification of normal and abnormal ; it is abnormal for a virus to behave as a cancer cell which is what this virus does , the term used to identify this anomolly is retrovirus . This leads me to ask the following two questions , ?is tis phenotype a result of autoimmune expression, and why would antiretroviral medication be prescribed to destroy DNA when what should have been done is to protect the DNA which are being attacked by a retrovirus . Strengthening the organism by way that it can fight off the attack of he virus is a better choice in clinical practice not weakening the organism with antiretroviral medication for a virus whose very existence rests on particulate  matter .

Refernces
Gregg , M (2004) Field Epidemiology 3rd ed Oxford University                                 

Homeopathy and their Uses in Public Health

Naturopathy often referred to as natural medicine is based on the belief hat the cause of disease is a violation of natures law ( Balch ,2002 ). We can also assert this premise when we and compare it to Nurse theory such as Martha Rogers Metaparadigma entitled Science of Unitary Human Beings ; and that of Nurse Theorist Betty Neuman whose Metaparadigma is entitled Systems Theory and based on energy (Nurse theory.org 2018) . The goal of the naturopath is to remove the underlying causes of disease and to simulate the bodies natural healing process. Naturopathic treatments include : fasting , vitamins and supplements , counceling , tissue minerals herbs and homeopathic remedies , as well as massage therapy acupuncture and application of water , heat , cold , sunlight and electricity.

Most methods are used to detoxify the body and strengthen the immune system  A proportion of Naturopathic supplemental medicine can be utilized to compliment ongoing treatment of disease or to tailor preventative measures in such chronic diseases as HIV and AIDS , Diabetis , Drug Addiction , and Mental Illness . Homeopathic remedies can also be described as Folk Medicine as this is the proper term used in North America   when referring to the use of herbs to compliment treatment of disease or when describing  home made remedies.

The ancient Chinese  recognized a vital energy behind al life forms and processes called qi pronounced Chee ; oriental practitioners believe that energy flows along specific pathways called meridians . Each pathway is associated with a particular physiologic system and internal organ . This is not surprising and should be well incorporated in science because in traditional medicine t s a wel kown fact that not all organs age at the same time , some may age or become disease sooner than others and when this occurs there may be an imbalance in energy be it in expenditure or lack thereof . We also corroborate these concepts when we evaluate Betty Neumans System theory and Martha Rogers Nurse theory .  Why is this important to preventative care and public health? Because when we concider that over 60,000 people died from drug overdose in the year 2016 we evaluate complimentary care as a vital tool in both tailored rehablitaton and in ealth care as a whole

References
Balch, P.A (2002) Prescription for Nutritional Healing . The A-Z Guide to Suppliments.  New York  USA    

Contrasting Locards Exchange Principle and Carbon Foot Printing . Whatta Relationship

Every contact you make with another person ,place , or object results in an exchange of physical material. If you own a pet this exchange of material is well known to you(Lyle ,2012)  Known as he Locard Exchange Principle after Edmond Locard the French police officer who first noticed it ; the exchange of materials is the basis of modern forensics investigations . Using the principle forensic scientists can determine where a suspect has been by analyzing trace evidence (Any Small ) pieces of evidence  such as fibers on clothing , hair in cars , or that gunk on the bottom of a shoe can be evaluated and analyzed  as well as used as corroborative evidence to seek an indictment of a suspected criminal . The premise here is the method and the principle as overarching process in scientific application ; how ever what would happen if we applied the same principle to  the carbon foot print principle ? . Can we make the contrast between the two principles in using trace evidence in carbon foot print to indict environmental criminals ? The proposal is not to far fetched . Infact forensic anthropologist use relevant concepts when engaged in field study . One of the discoveries made in Isreal were that solid fuel were used to prepare meals during the BC years ;these are years before crist . Why is this relevant to the topic under study ? because they also noticed environmental changes in the region  under there study to manifest climate changes similar to the climate changes seen today. When we appraise the two principles ; Carbon Foot Print and Locard Exchange Principle these demonstrate similar approaches in seeking out evidence which will allow a just accountability I human behavior . What are the implications of these principles to public health ? Well the implications vary ; but one of the most important tools used in public health are public health law which allows for the application of both principles when environmental protection is concerned . The interesting premise are that of using Locards Exchange Principle in public health research ; particularly if this research is placed within a public health law design . Carbon foot printing needs to be a part of all human activity and should be taught in elementary schools beginning in the fifth grade when children begin developing moral and ethical values ; Erickson called this developmental stage Industrial stage . This application will teach children about accountability for there behavior  within there environment and accountability in other environments . What say you ?

References
Lyle, D.P (2012) Forensics for Dummies . Wiley Publishing USA