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17 Feb 2019

Some of you are likely thinking of entering the medical field and it is an exciting time to be doing so! As you know the government passed a health care bill, Affordable Care Act (ACA) aka Obamacare, in 2010 that proposes some changes that will be in place at varying times; some laws went into very quickly after passage while others are not in place until this year. Task: Do some research on the new health care bill and what things will and will not change with our health care system. Students with last names beginning with M through Z will take the "Pro" view of the new health care bill and will point out its merits. Students with last names beginning with A through L will take the "Con" view of the bill and point out its faults. Also feel free to share personal stories of health care issues and what other changes you think might work for our flawed health care system. Before you begin posting, be sure to do some solid research on the topic. This is not about politics, so don't focus your thinking or post on it. Focus on what the bill actually states. Then argue your point (either "Pro" or "Con") based on your last name using solid facts you find during your research. Be sure to cite your sources so others can check them out when responding to you.

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officer-agLv10

28 Jan 2023

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Jean KeelingLv2

18 Feb 2019

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I will like you do grammar check, and rewrite it in another form. This is to avoid plagirsm. Thank you.

The purpose of this research is to explain some advantages and disadvantages of the implementation of the electronic medical record in a general hospital and specific units such as Neonatal intensive care unit. Also, it will emphasize different challenges that physician face when using the eMR as well as some solutions they offered in order to help them to overcome the challenge of typing. Most importantly, it will focus on the beneficial use of the eMR such as reduced time when charting specially in nursing as they spend a lot of time when documenting, it will reduce the time in half when using electronic medical record. Also, the research will review how the electronic medical record can enhance the quality of care to the patient. The electronic medical record will provide all the information needed by the physicians or any health care provider when giving care especially the critical patient who needs a quick intervention. This reseach will provide some information on how the eMR can improve quality of care. On the other hand, it will be discussed how the use of eMR can affect the relationship between a health care provider and the patient. As we know, health care providers have to keep a professional but close relationship with their patients in order to provide care and give the best intervention. However, when a health care provider uses electronic medical record some information might be lost when typing from a paper-based system into the eMR. The journals discuss multiple solutions to overcome and to reduce the risk of losing important information of our patient when typing or scanning the information into the eMR. Ventura, M.L., Battan, A.M., Zorloni, C., Abbiati, L., Colombo, M. Farina, S., & Tagliabue, P. (2011). The electronic medical record: pros and cons. The journal of maternal- fetal and neonatal medicine, 24(1), 163-166. doi: 10.3109/14767058.2011.607582 In this journal, researchers want to implement an electronic medical record in a neonatal intensive care unit. This system will enhance critical patientâs treatment because it will implement bedside clinical observation with machine monitoring data, and results from the laboratory. The time of charting for nurses was reduced but medical staff complained about the lack of automation in the reports. Through this journal researchers demonstrate that even though electronic medical record is beneficial because it reduces the charting time, it also can increase the risk for system error which can be fatal for the patients. In conclusion, electronic medical record should be reviewed for any complication that can influence patientâs life. Fox, G. S. (2014). The people versus the electronic medical record, last Thursday. Acad Pshychiatry, 38, 368-372. doi: 10.1007/s40596-014-0042-x In this journal, physicians express their concern about the use of electronic medical record. Physicians believe that the use of technology interferes with the face to face discussion between patients and doctors. Physician stated that the essential and precious communication has been diminished for both care givers and patients. Indeed, I believe with the use of electronic medical record, the lack of interaction and eye contact between the care giver and patient is increasing. This journal is really relevant within the nursing profession because it raises awareness of how important it is to keep the essential of communication between patients and health care providers. In brief, health care providers should find other way to obtain and record patient information to support the doctors and patient relationship. Ossoff, R. H., Thomason, C. D., & Appleton, J. (2010). Challenges with the electronic medical record. Journal of Health Care Compliance, 12(6), 51-54. Retrieved from http://search.proquest.com/docview/822639350?accountid=3455 The authors in this article examine the different challenges that doctors are facing with the use of electronic medical record. Firstly, physicians have to take training to learn how to use the system. However, to overcome the challenge of typing, physicians proposed an idea of creating well detailed templates that list all organs systems. Indeed, templates should be used just as a baseline of information, to help the users to remember the key elements while adding the patientâs information. This is a good point in documentation because even though templates are easier to fill out, medical staff should keep in mind that documentation should be well detailed. Although the templates might be well detailed, it is better to write your own finding when assessing a client. As the authors mention, templates should be used only as a baseline information. The population of interest regarding this journal will be health care providers and people that might want to go into the health care profession. Perez, S., & Keijzers, G. (2012). Missing data in the electronic medical record. Emergency medicine Australasia, 24 (4), 465. doi: 10.1111/j.1742-6723.2012.01564.x The authors of this research explain the problems that caused the transition from paper-based system to electronic medical record. With the implementation of the eMR all paper-based data are scanned into the eMR using pdf files and then destroyed. This caused many missing information in the eMR because they were destroyed before being verified in the eMR. Some solutions were addressed in this journal including; depositing the data collection sheets and separating them from the medical charts and placing them in the data collection boxes. This might decrease the loss of a patientâs important information. In brief, this journal addresses a very important topic about the importance of completely transferring the patientâs information into the eMR. Also, it creates an awareness to keep paper documentation even though the eMR is present. Hoffman, M.A., & Williams, M.S. (2011). Electronic medical records and personalized medicine. Hum genet, 130, 33-39. doi: 10.1007/s00439-011-0992-y The authors emphasize two important aspects of a fully functional electronic medical record. Firstly, it is necessary to present patients or clinicians with a high quality context detailed information when providing care. Secondly, the users must combine clinical information from different sources in order to guide the clinician to improve intervention for a given patient. According to this journal, the use of electronic medical record can increase quality of providing care. As health care professionals our main goal is to provide the best intervention to our patient and this journal proved that the use of eMR can improve the intervention given to the patient. This is because it can give doctors a quick access to patientâs information in a critical scenario or even when just proving care.

plumplatypus115

1) The neurotransmitters acetylcholine and norepinephrine are digested by enzymes that are located at the axon synapse or within the axon terminal of the neurons.

a)What are the names of these different types of enzymes?

b)Where are they located and what is the result of their enzymatic activity?

2) Explain how the Investigational New Drug process works as well as the four different phases of clinical trials. Why are some drugs still taken off the market after approval by the FDA?

3) A single IV injection of 100 mg drug with a half-life of 4 hours is administered to a young adult.

a) Plot drug concentration versus time on a graph making certain to clearly label.

b) How long will it take to eliminate > 95% of the drug?

c) If the volume of distribution is 4L, what is the clearance of the drug?

4) Many drugs are metabolized in the liver through the microsomal metabolizing system.

a) What specific enzymes are involved in this metabolism?

b) What are the main functions of these enzymes?

c) What are some factors that can contribute to individual drug metabolism variation? Explain.

5) Think of an emergency situation requiring immediate and intense physical exertion.

a) List as many body organs as you can and predict the desired level of activity [increased or decreased].

b) Which neurotransmitter would produce these effects and through what receptors?

6) It is interesting that a drug can produce a therapeutic effect and an undesired side effect in one situation, and that the same drug side effect may be considered a therapeutic effect in another situation. Explain this phenomenon using the drug promethazine as an example.

7) A patient brought into the emergency room is experiencing severe hypotension. Blood pressure reads 90/50.

a) What class of drugs is indicated for treatment and why?

b) What precautions should be observed when these drugs are administered?

c) What would be the first indication that too much drug has been administered?

8) Only certain drugs are capable of crossing the blood brain barrier.

a) How is the blood brain barrier different than barriers found in other areas of the body? Be specific.

b) What properties of drugs will make it more likely to cross the blood brain barrier? Explain your answers.

9) A 32-year-old, presents to the Emergency Department by ambulance with vomiting, confusion, salivation, and respiratory distress. The patient states that he was feeling fine until today when I started getting ill. He then vomits. During a physical exam you record the following information: Heart rate 45; Blood pressure 90/60; Respiratory rate 25; Temperature 36.6C; Pupils constricted. During your exam, 4 more ambulances arrive with patients with similar symptoms. You find out they were all riding in the same care on the Red Line when they began feeling ill.

a) What do you feel is happening and why?

b) Would you expect their symptoms to improve over time? Why or why not?

c) What drug would you prescribe to treat these patients and why?

10) Betty has diabetes and asthma. She also has developed high blood pressure, for which doctor just prescribed propranolol. One of your duties as a physicianâs assistant is to make sure patients are not prescribed drugs that are contraindicated because of other health problems.

a) What should you tell the doctor about Bettyâs prescription for propranolol and why?

b) Is there a more appropriate drug for Betty? Explain you answer.

Water and Minerals

COLLAPSE

This discussion requires knowledge of the material from the chapter and research from online databases or valid research sources. This is truly an excellent learning experience for all of us.

Cancer and Chronic Disease (parkinson's, alzeimers, MS, CVD, auto-immune etc) are words that scare most of us. Certainly when it comes to prevention research shows that smoking, excessive alcohol use, exposure to toxins, obesity, poor diet, lowered immunity, inflammation are all implicators. We can definitely reduce our risk with good lifestyle choices (not smoking, normal BMI, etc.) and that includes dietary choices. There is quite a bit of research and debate about which minerals are beneficial for cancer and/or disease prevention (if at all) and research changes often. You can also focus on water, this will probably lead you down a track to discussing the effects of certain pollutants in the water supply. In any case we are going to find that research and share the knowledge!

This week, for your original posting, find a scholarly based article, professional journal article, original research from grey literature (www.greylit.org) or well respected organization/association research on diet and cancer or chronic disease prevention. This could include the presence of minerals, as supplements or from food, or something related to the water supply and cancer/chronic disease prevention, special diet for cancer/chronic diseases prevention etc. It can be specific to a particular type of disease or cancer or more general. If you select a chronic disease, select one specific one. We are on the minerals chapter, so I would like to see research focused on a mineral or that includes a mineral or multiple minerals. (for example though, don't research a high protein diet as that is a macronutrient).

What to consider:

1. Two wasy to navigate sources for you: get on Google scholar: https://scholar.google.com or for non-published research you can query: www.greylit.org OR have the MC librarian direct you to the various databases you have access too (you can call MC library and they will help you if you are fully online and don't want to go in). Absolutley NO wikipedia, livestrong or webmd, Mayo type sites. You can start here for topic ideas but look further! We are looking for scholarly research. Professional organizations are also a good place as well (for instance, I am interested in digestive conditions, and utilize the American Gastroenterological Association site which links to their journal).

2. find something you are interested in and use that as the basis of your search. This could be information from chapter 8. Also remember, it does not just have to be cancer, you can select any chronic condition you are interested in and see if there is research related to vitamins, minerals or phytochemicals.

3. **In many cases on Google Scholar you can see several version of an article and often you can access a free PDF version of the full article. If NOT, call the MC library and ask for our college log on and see if we have rights to the article. They may have given this info to you but I have found most students have to ask. OR the MC library will actually retrieve the full text article for you and email you the PDF, utilize the librarians!! They love it. **do NOT pay to purchase a full text article online! Utilize the MC library!!

3. If you find an article of interest in a regular magazine or paper (print or online) like Health magazine online, New York times, Wall street journal etc. and you like it, then at the END of the article or referenced IN the article will be information on the original research where the writer got the information. You can discuss the general article in your research but also find the original scholarly article online! **include both in your original posting as attachments or links.

For your original posting:

1. in the Subject box put the topic you researched i.e. lead contaminated water and the effects of cognitive development

2. Then post your article (and include either a link or preferabley the pdf or word doc so we can see the entire article). and also provide a detailed summary of the information you read about and if you agree or disagree with the information. Also discuss why you selected this particular article. **document the source appropriately, I am not concerned if you use APA or MLA.

3.**IMPORTANT, for full points YOU are summarizing what the article/research study said in your own words and discussing merits, issues, if you agree, disagree etc. I am having you attach the article/research study you referenced instead of just a works cited info so others in the class can access the information as well. **you are not cutting and pasting the abstract!!