The Future of Public Health,” the Institute of Medicine of the National Academies (1988) recognizes assessments of community health status.

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The Future of Public Health,” the Institute of Medicine of the National Academies (1988) recognizes assessments of community health status.

In its report “The Future of Public Health,” the Institute of Medicine of the National Academies (1988) recognizes assessments of community health status and community health needs as a core public health function. The course textbook states that some of the goals of community health assessment are to evaluate health status, identify community health needs, identify strengths and weaknesses of a community’s health systems, recommend strategies to address community health needs, and locate existing or needed resources to meet identified needs.

Read the report and based on it, respond to the following questions in relation to the role of community members:

  • What role or roles should community members have in a community needs assessment? Justify your answer.
  • What are some strategies for engaging community members?

Public health agencies use data to identify health problems, establish and track health objectives, and assess the effectiveness of policies, programs, and services.

Respond to the following questions in relation to community needs assessment:

  • Which key factors are important to consider when gathering and presenting data for a community needs assessment?
  • When presenting data, which strategies would you recommend for creating a strong and compelling statement of need?

Part 2

Continuous quality improvement (CQI) refers to the process of continually assessing and adjusting a program or service components to address problems or enhance results. The CQI process is dynamic and ongoing, guided by input or feedback from individuals receiving the services. Additionally, buy-in and support from the staff, particularly staff responsible for implementing program changes, are critical to an agency’s CQI efforts. Selecting the right individual to lead an agency’s CQI efforts is important if these criteria are to be achieved.

Using the Internet, research about CQI in public health systems.

Based on your research, respond to the following discussion points in relation to CQI activities:

  • Describe the ideal traits or characteristics of the person or team who would spearhead the CQI process.
  • Examine how CQI leaders can garner support and buy-in from staff responsible for CQI activities.

CQI leaders are critical to the success of an agency’s CQI efforts. Effective CQI leaders help establish a shared vision and purpose provide direction, and ensure the availability of resources and the right environment required for success.

Respond to the following discussion points in relation to managing CQI efforts:

  • Examine the advantages and disadvantages of assigning an existing staff person to manage CQI efforts versus engaging an external contractor.
  • Explain which of the two you would recommend for managing CQI efforts.

Reference:

Institute of Medicine of the National Academies. (1988). The future of public health.

What is the relationship between alcohol and breast cancer?

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What is the relationship between alcohol and breast cancer?

 

Research nursing questions

Order Description

Review the following research questions.

1. What is the relationship between alcohol and breast cancer?

2. What is the difference between self-efficacy scores in older adults who exercise and the scores of those who do not?

3. What is the difference in attitudes of male and female college students toward condoms?

Address the following as per rubric:

• Identify an appropriate research design.

• Discuss the strengths and weaknesses of the design.

• Provide a rationale for the design you selected

Ally is a 17 year old female with a two year history of Crohn’s Disease, and currently studying Year 12

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Ally is a 17 year old female with a two year history of Crohn’s Disease, and currently studying Year 12

Ally is a 17 year old female with a two year history of Crohn’s Disease, and currently studying Year 12

Ally is a 17 year old female with a two year history of Crohn’s Disease, and currently studying Year 12. Ally arrived for admission to the Day Surgery Unit (DSU) at Lakewood Drive Medical Centre for a routine colonoscopy and biopsy scheduled for theatre at approximately 10.00 hrs.

Ally was admitted to the DSU by the registered nurse (RN), Sharon. The consent was checked as part of the procedure, and Sharon noted that consent had been given by Ally’s father for colonoscopy and biopsy. Ally’s vital signs were recorded as: temperature: 37.2; pulse: 70 bpm; respirations: 16bpm; and blood pressure 110/75 mmHg.

Ally was transferred to theatre for the procedure at midday because an emergency surgical case earlier in the morning caused a significant delay for all elective procedures. Following the colonoscopy, Ally returned to the DSU ward at 1400hrs. Her condition was haemodynamically stable and she was fully conscious although complaining of mild abdominal pain (pain score 3/10). She also said she felt she was ‘leaking slightly’ from the bowel and thought it might be some diarrhoea. Routine (half hourly) observations were commenced.

The shift was chaotic due to the earlier disruption to the surgical list, and at 1450 hrs, Sharon realised that Ally’s observations were behind schedule. She quickly took Ally’s pulse and noted it was slightly tachycardic. She estimated the pulse rate as 108 and also noted some tachypnoea but did not chart this observation. Ally’s blood pressure was slightly lower than on admission at 90/50 mmHg and the abdominal pain had increased (pain score 7/10). She also stated she felt slightly light headed but Sharon suggested it was probably due to the fasting and bowel preparation (liquids only for 24 hours).

Sharon quickly handed over to the afternoon staff at 1500 hrs and was happy to go home after such a busy and stressful shift. At home, Sharon posted to her friends on social media her reflections of the day – she sarcastically ‘thanked’ Mr Jones, the surgeon, for giving her another miserable shift, and ‘thanked’ her 17 year old patient for whining about her abdominal pain after a simple colonoscopy procedure.

In the meantime, RN Joe took over Ally’s care and quickly noted that she had significant PR bleeding evident, increasing abdominal distension and her pain score had increased to 10/10. Her vital signs had also deteriorated. Joe told Ally that he had to notify the doctor immediately because she was bleeding, and in accordance with NSQHS ‘Standard 9,’ initiated a Medical Emergency Team (MET) call.

The attending team made the decision to take Ally back to theatre for an emergency ‘colonoscopy/laparoscopy +/- an open laparotomy.’ Ally’s dad (her mother died when she was seven) was uncontactable by phone. Ally was frightened and immediately

gave her own verbal and written consent for the surgery once the situation had been explained by the doctors.

Following complicated surgery where Ally had a partial colectomy for a perforated colon, she returned to the ward. The next day her vital signs were within an acceptable range and despite feeling tired and sluggish, she was slowly recovering.

One of Ally’s friends shared Sharon’s Facebook post with Ally and told her that the surgeon wasn’t very good and had a history of medical errors. Ally was furious and told the unit manager she was going to discharge herself, despite being advised that she needed several more days in hospital for pain relief, IV antibiotic therapy and wound manage

: Identify 3 problems that can occur during the process of familial visitation with the offender prior to her release from incarceration.

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: Identify 3 problems that can occur during the process of familial visitation with the offender prior to her release from incarceration.

The experiences of a group of mothers reentering the community after a period of incarceration are explored. The authors are particularly interested in how incarceration and subsequent reentry influence mothers’ family relationships and primary risk and protective factors. Eighty-min interviews are conducted with 28 women probationers who had at least one minor child and had undergone incarceration at least 2 months prior to release. Descriptive analyses reveal that mental health risks characterize many mothers in this study, resource adequacy and parenting stress are significantly related, and family support is an important factor in successful reentry. It also appears that incarceration, even for short periods, is associated with shifts in family configuration on mothers’ release by increasing the likelihood of divorce and decreasing the likelihood that mothers will reside with the father of at least one of their biological children. Implications for intervention and directions for future research are discussed.
Respond to the following prompts, writing a minimum of 175 words per prompt:

Identify 3 problems that can occur during the process of familial visitation with the offender prior to her release from incarceration.
How will those problems affect the relationship between the mother and her family once she is released from incarceration?
Analyze some ways that family member support can benefit the mother once she is released.
How might a mother’s perception of community resources affect her motivation to obtain community resources once she reintegrates into the community?
Identify 3 specific community supports, and share some viable strategies for connecting mothers’ with community supports.
Format any citations according to APA guideline

Explain the goals of and differentiate between basic and applied research.

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Explain the goals of and differentiate between basic and applied research.

 

The Role and Importance of Research

Content
Matt’s Summaries and Self-Proclaimed Words of Wisdom
Attached Files: o Welcome from Matt.wmv (90.059 MB) Article Preference for Group Assignment
This is a survey to indicate your top 3 article preferences for the small group activity.
Overview
The goal of this unit is to get you thinking and talking about what research is and why it is important to your life and work. Through the readings and online discussions, you will learn the basic, essential characteristics of research and the different ways it is used in healthcare.
Objectives
• Explain why research is important.
• Describe the difference between Qualitative and Quantitative research.
• Explain the goals of and differentiate between basic and applied research.
Readings
Salkind, Chapter 1: “The Role and Importance of Research”
Smith, J. K. (1983). Quantitative versus qualitative research: An attempt to clarify the issue. Educational Researcher, 12(3), 6-13.
Unit 1 Full Class Discussion
Introduce yourself to your classmates, and post your initial thoughts about how both qualitative and quantitative research fit into your daily work.
Extras
The Scientific Method from Explorable

4-5 pages due by Feb 4 … You have learned many of the basic elements of a chemical dependency center in today’s world. Now it is time to write a report that will be used in a final proposal for a new treatment center.

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4-5 pages due by Feb 4 … You have learned many of the basic elements of a chemical dependency center in today’s world. Now it is time to write a report that will be used in a final proposal for a new treatment center.

Consider what you have already learned, and continue your research about addiction and recovery theories, services, and continuum of care to design the most effective treatment center possible. Based on current issues that you have learned about, consider the changes you believe could be made to improve this evolving system.

Start with some of the following questions:

What do you think the future best practices might look like?

How might you care for the professionals in a field while they are caring for their clients?

What kind of professional development will the staff need to make this center a success? How might this improve services to those in need?

Given what you know and what your group discovered and discussed about modern treatment facilities, use your imagination to come up with a futuristic model of an addiction and recovery services center. Be sure to address the following information in a proposal of 4–5 pages:

Objective

Type of facility

Need for the facility

Purpose of the facility

Current issues or challenges the facility is designed to address

Mission statement of the facility

Philosophy or theories practiced within the facility

Logistics

Essay On The Treatment Of Plaque Psoriasis

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Use of Tildrakizumab in the Treatment of Moderate-Severe Plaque Psoriasis

Plaque Psoriasis



Psoriasis is a chronic, inflammatory autoimmune condition that affects the skin, nails and joints. There are a number of different types of psoriasis such as pustular, flexural and guttate psoriasis. The most common of these is known as plaque psoriasis. Plaque psoriasis most commonly presents in patients as red or silver, scaly, itchy patches on any area of the skin  although it affects mostly the knees and elbows (Better Health Channel, 2018). These scales are known as plaques and are a result the body creating excessive skin cells.

This inflammation is likely to be a response of the immune system; however, it is believed that other factors contribute to the disease. This condition is not life threatening and can be well managed with pharmacological treatments, particularly with recent drug developments. One of these drugs is tildrakizumab, a biological agent which is used to reduce the immune response and thus induce remission of the condition. Despite having these advances in pharmacological treatments, there is no cure for plaque psoriasis and in many cases the condition will involve periods of exacerbation and remission.

Pathophysiology of Plaque Psoriasis

The pathophysiology of plaque psoriasis is mostly unknown; however, it is believed to be related to a number of factors; including, genetics, immune system and environment. In recent years, research has been able to give a better understanding of the immunological pathophysiology which has allowed for the development of targeted drug therapies (Beck et al., 2018). In many cases, there appears to be a strong genetic link between family history and the development of the disease. If one parent is affected, the risk of their offspring developing plaque psoriasis increases by 16%. If both are affected, the risk increases by 50% (Handa and Mahajan, 2013). There are also a number of different environmental factors that may contribute to the development of plaque psoriasis including stress, infections and the use of medications such as beta-blockers, tetracyclines and alcohol. The best-known cause for plaque psoriasis is an unnecessary activation of the immune system which causes the body to produce markers such as insulin like growth factor (IGF) and epidermal growth factor (EGF). The increase in EGF causes an increase in the production of epidermal cells and contributes to the formation of plaques (Badri and Oakley, 2018).

Current Therapies for Plaque Psoriasis

Current therapies include a range of pharmacological and non-pharmacological methods which are used to control the symptoms. Non-pharmacological therapies include phototherapies and the use of emollients. The light therapies use short wavelengths of UVA and UVB light to prevent the over proliferation of skin cells by dampening the immune system (Nakamura, Farahnik and Bhutani, 2016).

Pharmacological therapies are classified into topical, systemic and biological therapies. Topical therapies include the use of lotions, creams, ointments and gels containing the drug. Corticosteroids such as betamethasone, vitamin D analogues such as calcipotriol, retinoids such as tretinoin as well as coal tar, dithranol and salicylic acid or urea products (Todd et al., 2010). Corticosteroids have an anti-inflammatory and immunosuppressive action as well as reducing cell proliferation by binding to the nuclear glucocorticoid receptor, which changes the production of proteins in the cell (Kwatra and Mukhopadhyay, 2017). Vitamin D analogues reduce the proliferation of keratinocytes in the skin and display anti-inflammatory properties (Barrea et al., 2017).

Systemic therapy for plaque psoriasis include those that are administered orally or parenterally. These are usually reserved for cases of plaque psoriasis which are resistant to topical treatment or those that are very complex or severe. Such treatments include prednisolone, methotrexate, cyclosporine, mycophenolate, leflunomide and other immunosuppressive agents (Kelly, Foley and Strober, 2015). Most of these immunosuppressive agents work by reducing the activity of T-cells in the immune system, either by suppressing proliferation or by preventing the activation of these cells (Pillans, 2006).

In recent years, the emergence of biological agents known as monoclonal antibodies have vastly improved the way plaque psoriasis is treated. Monoclonal antibodies are drugs that have been engineered to target a specific mediator in the immune system and has proven useful in the treatment of autoimmune diseases, including plaque psoriasis. The earliest biological therapies targeted the production of T cells, preventing their proliferation and include alefacept and efalizumab (Maverakis et al., 2010). Although these agents were seen to be very effective, newer agents targeting Tumour Necrosis Factor (TNF-) which is involved in the immune system’s inflammatory response and include adalimumab and etanercept.

Tildrakizumab

A newer monoclonal antibody, called tildrakizumab, has recently been approved by the US Food and Drug Administration (FDA). Tildrakizumab is a humanised IgG1 antibody which targets interleukin 23, one of the cytokines believed to be responsible for the immune system’s inflammatory response in severe plaque psoriasis (Markham, 2018). This antibody was originally produced in mice and has been bioengineered to create a very similar, humanised version. Tildrakizumab works to selectively inhibit the p19 subunit that is found on interleukin 23 in the body and neutralise it, preventing the inflammation of the skin (Beck et al., 2018). This antibody has been engineered to have a high affinity for the p19 subunit and as such is effective in exerting its effects.

One of the risks associated with the use of monoclonal antibodies is an increased risk of infection, such as tuberculosis. Phase III studies of tildrakizumab suggest that the drug has a relatively low risk of infection compared to other monoclonal antibodies that are currently being marketed and as such could be safer than the earlier therapies (Crowley et al, 2018).

Further phase III studies suggest that that doses of 200mg and 100mg were efficacious in the treatment of moderate to severe plaque psoriasis, when compared to a placebo and etanercept. The same study also found that the use of this drug was well tolerated in patients treated with this medicine (Reich et al., 2017). A similar trial stated that there was a similar efficacy, with patients who relapsed during treatment able to reach a similar level of effectiveness (Papp et al., 2017). According to late phase II trials, the main adverse effects of tildakizumab appear to be related to infection in the bones and skin (Papp et al., 2015).

Conclusion

In conclusion, the development of tildakizumab has shown very promising results in the treatment of moderate to severe plaque psoriasis. Tildakizumab is a high affinity monoclonal antibody which targets the p19 subunit of interleukin 23 to dampen the inflammatory response of the immune system. Several studies have shown that this agent has less adverse effects in comparison to its predecessors, adalimumab and etanercept, although it demonstrates a similar efficacy.

References:

  • Barrea, L., Savanelli, M., Di Somma, C., Napolitano, M., Megna, M., Colao, A. and Savastano, S. (2017). Vitamin D and its role in psoriasis: An overview of the dermatologist and nutritionist. Reviews in Endocrine and Metabolic Disorders, 18(2), pp.195-205.
  • Beck, K., Sanchez, I., Yang, E. and Liao, W. (2018). Profile of tildrakizumab-asmn in the treatment of moderate-to-severe plaque psoriasis: evidence to date.

    Psoriasis: Targets and Therapy

    , Volume 8, pp.49-58.
  • Better Health Channel. (2018).

    Psoriasis

    . [online] Available at: https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/psoriasis [Accessed 6 Oct. 2018].
  • Handa, S. and Mahajan, R. (2013). Pathophysiology of psoriasis.

    Indian Journal of Dermatology, Venereology, and Leprology

    , 79(7), p.1.
  • Kwatra, G. and Mukhopadhyay, S. (2017). Topical Corticosteroids: Pharmacology. A Treatise on Topical Corticosteroids in Dermatology, pp.11-22.
  • Todd, A., Anderson, R., Groundwater, P. and George, S. (2010). Current and potential new therapies for the treatment of psoriasis.

    The Pharmaceutical Journal

    , [online] 284(6), p.560.
  • Markham, A. (2018). Tildrakizumab: First Global Approval.

    Drugs

    , 78(8), pp.845-849.
  • Maverakis, E., Bowen, M., Raychaudhuri, S., Sivamani, R., Correa, G. and Ono, Y. (2010). Biological therapy of psoriasis. Indian Journal of Dermatology, 55(2), p.161.
  • Nakamura, M., Farahnik, B. and Bhutani, T. (2016). Recent advances in phototherapy for psoriasis.

    F1000 Research

    , 5, p.1684.
  • Papp, K., Kimball, A., Tyring, S., Metha, A., Cichanowitz, N., Li, Q., Green, S. and La Rosa, C. (2017). Maintenance of treatment response in chronic plaque psoriasis patients continuing treatment or discontinuing treatment with tildrakizumab in a 64-week, randomized controlled, phase 3 trial. Journal of the American Academy of Dermatology, 76(6), p.AB164.
  • Papp, K., Thaçi, D., Reich, K., Riedl, E., Langley, R., Krueger, J., Gottlieb, A., Nakagawa, H., Bowman, E., Mehta, A., Li, Q., Zhou, Y. and Shames, R. (2015). Tildrakizumab (MK-3222), an anti-interleukin-23p19 monoclonal antibody, improves psoriasis in a phase IIb randomized placebo-controlled trial. British Journal of Dermatology, 173(4), pp.930-939.
  • Pillans, P. (2006). Experimental and Clinical Pharmacology: Immunosuppressants – mechanisms of action and monitoring. Australian Prescriber, 29(4), pp.99-101.
  • Reich, K., Papp, K., Blauvelt, A., Tyring, S., Sinclair, R., Thaçi, D., Nograles, K., Mehta, A., Cichanowitz, N., Li, Q., Liu, K., La Rosa, C., Green, S. and Kimball, A. (2017). Tildrakizumab versus placebo or etanercept for chronic plaque psoriasis (reSURFACE 1 and reSURFACE 2): results from two randomised controlled, phase 3 trials. The Lancet, 390(10091), pp.276-288.

Explain the principles and practices of Primary Health Care (PHC).

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Explain the principles and practices of Primary Health Care (PHC).

Application of PHC concepts and health promotion practice with particular reference to the Indigenous Australians

Length: Maximum 750 words PLUS Poster
Aim of Assessment
The aim of this assignment is to provide you with the opportunity to gain a deeper understanding if the application of PHC concepts and health promotion practice with particular reference to the Indigenous Australians.
The following Learning Outcomes 4,5,6 and 7 are addressed in this assessment:
Explain the principles and practices of Primary Health Care (PHC)
Explain health promotion as a strategy with a PHC framework
Explain how social determinants of health can inform primary health care
Using a PHC framework, identify strategies that can be used to overcome family violence
Details of the assessment
A video concerning an Australian Indigenous health issue will be used as a trigger for students to respond to 3 written questions PLUS a poster relating to the social determinants of health (SDH), primary health care (PHC) principles and health promotion elements identified in the video.
I order to complete the assessment you will:
• Access and view the video: “Violence is getting worse:” Indigenous women speak up about family violence” a few times so that you become familiar with the content.
• Reflect on the content
• review on-line learning materials. Reflect on what you have learnt about the health of Indigenous Australians and factors affecting their health.
• Read and watch the additional learning materials and do some searches yourself for background material about PHC, health promotion and Australian Indigenous health, as well as other programs aimed at improving the social determinants of health for Indigenous Australians
• Please submit your answers in question-answer format NOT essay format i.e. number your answer to each question.
• Answers to questions 1-3 will have a maximum word limit that will total 750 words (250 words each question).
• In-text references and reference list does NOT contribute to the word count.
• Additional to the written component, a health promotion poster specific to Indigenous Australians will also be submitted.
• The poster does not contribute to the assessment word limit.
• Following on from the reference list for the written assessment provide the heading ‘poster reference list’ and provide a reference for each image and text reference that you used for the poster.

Assessment 2: Assessment questions
Question 1:
Describes what is meant by ‘social determinants of health’.
Provide at least 3 examples of social determinants of health (SDH).Relate how each of these determinants can inform primary health care to help individuals maintain their health and wellbeing.The above questions are not specific to the video.Your answer should be underpinned by the nursing and health care literature.
(250 words)

Question 2:
Aboriginal women represent three per cent of all women in Australia, yet they make up six times that amount in family violence victims:
From the video:
a) Identify 3 social determinants of health (SDH) that impacted the Indigenous communities in relation to family violence.

b) Discuss how each of these social determinants of health impacted on the Indigenous communities in relation to family violence

(250 words)

Question 3:
Not specific from the video. Identify the ‘principles of primary health care’ (PHC).
From the video: Discuss how at least 3 principles of primary health care were used by the communities to develop strategies to overcome family violence, as identified in the video.Your discussion should be underpinned by the nursing and health care literature.

(250 words)
Some resources to help you with Assessment 2:

Australian Indigenous Health promotion resources-family violence (lots of resources)
http://www.healthinfonet.ecu.edu.au/related-issues/family-violence/resources/health-promotion-resources
Submission to the Royal Commission into Family Violence_2015
http://www.melbournecitymission.org.au/docs/default-source/position-papers/melbourne-city-mission-submission_royal-commission-into-family-violence.pdf?sfvrsn=0
Family violence (general) what is it, why does it happen, how does it start? Effects on family life etc.
http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&np=99&id=1555
Domestic violence in Australia: a quick guide to the issues
http://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp1415/Quick_Guides/DVinAust
Communities working to reduce Indigenous family violence
http://www.indigenousjustice.gov.au/briefs/brief012.pdf

Scoping study of health promotion tools for Aboriginal and Torres Strait Islander People e.g. what are health promotion tools/who is the intended audience?
https://www.lowitja.org.au/sites/default/files/docs/Health_Promotion_Tools_Scoping-Study.pdf
Social determinants and the health of Indigenous peoples in Australia – a human rights based approach

What are the similarities to the U.S. healthcare system?

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What are the similarities to the U.S. healthcare system?

Review the health policies of each of the following countries. Then, choose a country from the following list to compare and contrast with the current U.S. healthcare system:

China
England
Germany
Australia
Canada
Japan
Once you have thoroughly analyzed the health policy information for your chosen country, answer the following questions:

What is the main focus of the policy standard in this (chosen) country?
What are the similarities to the U.S. healthcare system?
Governance
Workforce
Leadership
Quality
How does the U.S. healthcare system differ in terms of policy?
Where do you foresee the U.S. healthcare system in the future (long-/short- term)? ( Review from one of the the following perspectives: the provider, the patient, or other stakeholders)
Summarize the meaning of universality in U.S. health policy versus your chosen country. (Include your research on the future of the U.S. healthcare system)
The paper:

Must be 4 to 6 double-spaced pages in length (not including title and reference pages) and formatted according to APA style as outlined in the Ashford Writing Center.
Must include a separate title page with the following:
Title of paper
Student’s name
Course name and number
Instructor’s name
Date submitted
Must use at least four (4) scholarly sources in addition to the course text.
Must document all sources in APA style as outlined in the Ashford Writing Center.
Must include a separate reference page that is formatted according to APA style as outlined in the Ashford Writing Center.

The Epidemic Transmission of HIV/AIDS – mother to child and the practice of treatment

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The Epidemic Transmission of HIV/AIDS – mother to child and the practice of treatment

Introduction

AIDS or the Acquired Immunodeficiency Syndrome is a chronic and serious disease which is caused by the Human Immunodeficiency Virus (HIV) which attacks the immune system and compromises the body’s natural and instinctual ability to fight off organisms, bacteria, and other viruses.  This disease is largely sexually transmitted and can also be transmitted from mother to child during pregnancy, breastfeeding, and childbirth (US Department of Health and Human Sciences, 2018).  It can also be transmitted via blood transfusions or contact with the blood of infected patients.  Without maintenance and treatment, this disease can continually compromise the individual’s immune system and make him vulnerable to diseases which can then cause his death (US Department of Health and Human Sciences, 2018).  At present, this disease does not have any cure, and thus far, it is becoming a global epidemic as more individuals, especially those in developing countries are being afflicted with it.  The immune system has a major role in protecting the body from diseases (World Health Organization, 2003).  The human body in general has a built-in immune system which is activated every time it is exposed to viruses and bacteria (World Health Organization, 2003).  In instances where an individual has AIDS, the human immunodeficiency virus attacks the CD4 cells which make up the immune system (US Department of Health and Human Sciences, 2018).  These cells are part of the white blood cells which primarily function to protect the human body from infection.  The HIV then applies the actions of the CD4 cells to replicate itself.  The action is repeated with all the replicated CD4 cells and as the CD4 cells replicate, to weaken the immune system of the body (US Department of Health and Human Sciences, 2018).

Main Body

The signs and symptoms of this disease are very much dependent on the stage of the infection.  During its acute stage, the symptoms of the disease include flu-like symptoms in the first one or two months when the virus enters the body (World Health Organization, 2003).  Symptoms include: fever, headache, muscle and joint pains, rashes, swollen lymph glands, and painful mouth sores (Mayo Clinic, 2018).  The acute stage is the stage where the virus volume is high and it spreads fast through the individual’s system and on to the next stage of the disease (Mayo Clinic, 2018).  In the second stage of the virus infection, known as the clinical latent infection or the chronic HIV stage, the lymph nodes are persistently swollen and no other signs and symptoms of the disease are noted.  The virus stays in the body and continues to infect the white blood cells (Mayo Clinic, 2018).  This period is likely to last about 10 years if the patient is not undergoing antiretroviral therapy (Mayo Clinic, 2018).

The third stage is the symptomatic HIV infection stage where the virus multiplies and destroys the individual’s immune cells (Mayo Clinic, 2018).  As a result, the individual may develop numerous mild or chronic infections including fever, fatigue, swollen lymph nodes, diarrhoea, weight loss, oral yeast infection, and shingles (Mayo Clinic, 2018).  With more efficient antiviral treatments, most HIV-positive individuals do not develop AIDS.  Without treatment, HIV can turn into AIDS within 10 years from initial infection (Mayo Clinic, 2018).  When AIDS sets in, the immune system is already severely compromised and the individual may be afflicted with opportunistic infections, including pneumonia and tuberculosis, as well as opportunistic cancers (Mayo Clinic, 2018).  These may be the immediate cause of death for these HIV-positive patients.  In the symptomatic stage of HIV, the signs and symptoms include soaking night sweats, recurring fever, chronic diarrhoea, unusual lesions on tongue or mouth, persistent fatigue, skin rashes, and weight loss (Mayo Clinic, 2018).

Pathogens like Toxoplasma gondii, Cryptococcus neoformans, and JC virus can cause infections of the brain and spinal cord for HIV positive patients (Chu and Selwyn, 2011).  Infections including other malignancies can lead to different neurologic symptoms, mostly associated with the severity of the disease (World Health Organization, 2003).  Individuals with solitary lesions mostly have headaches or focal deficits, while patients who have elevated intracranial pressure may experience visual disturbances and nausea (Chu and Selwyn, 2011).  Those with meningitis or encephalitis may manifest symptoms like fever, headache, or neck pain (Chu and Selwyn, 2011).  Studies indicate numerous deficits which are associated with neurotoxicity and inflammation, mostly among patients with low CD4 counts (Chu and Selwyn, 2011).  Impairment can be mild (asymptomatic neurocognitive impairment) to the more severe level of HIV-related dementia (Carillo, Clotet, and Blanco, 2011).  In general, these are known as HIV-associated neurocognitive disorders (Chu and Selwyn, 2011).  Dementia associated with HIV is associated with cognitive ability domains like memory and concentration. HIV is also associated with neuropathy such as polyneuropathy and lumbosacral polyradiculopathy (Chu and Selwyn, 2011). Some leg weakness and sensory loss can also be noted, including bladder dysfunction (Chu and Selwyn, 2011).  About 50 percent of HIV patients manifest psychiatric and substance abuse issues which are not directly related to infection, but can compromise the quality of life and impact treatment adherence (Chu and Selwyn, 2011).  Routine screenings on initial and regular visits are undertaken to detect these neurological impairments.

The virus appears to compromise the cardiovascular system by increasing cytokine levels, as well as causing chronic vascular inflammation as well as endothelial dysfunction (Chu and Selwyn, 2011).  With antiretroviral medications as well as infection, vascular effects are further affected by lipid and other metabolic changes (World Health Organization, 2003).  Cardiac assessment is undertaken for HIV positive patients based on the National Cholesterol Education Program, Adult Treatment Panel III guidelines with cardiac risk assessment and dyslipidemia recommendations established from these guidelines (Chu and Selwyn, 2011).  Other cardiac complications associated with HIV include cardiomyopathy, myocarditis, as well as pericarditis (Chu and Selwyn, 2011).

Pulmonary complications in HIV patients mostly manifest as the presenting symptoms for the disease.  Associated symptoms include fever, exertional dyspnoea, and non-productive cough (Chu and Selwyn, 2011). There may be other radiologic findings, but chest radiography results indicate bilateral infiltrates (Chu and Selwyn, 2011).  General management is efficient among patients with mild symptoms or CD4 counts at 200 per mm

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(Chu and Selwyn, 2011).  However where no improvements are noted after treatment, more diagnostic tests have to be undertaken with a possible severe pneumonia or even Legionella species diagnosis in mind (Chu and Selwyn, 2011).  Pulmonary arterial hypertension, COPD, and lung cancer are some of the other opportunistic infections noted among HIV positive patients in the past few decades (Carillo, Clotet, and Blanco, 2011).  While the actual aetiology of HIV-associated pulmonary hypertension has not been established, some vascular changes including fatigue, cough, and oedema have also been noted among patients with HIV infection (Chu and Selwyn, 2011).  Electrocardiography and echocardiography tests are early diagnostic tools for HIV-associated pulmonary hypertension.  Cardiac catheterization is also used to measure pulmonary pressure and help manage treatment (Chu and Selwyn, 2011).  Treatment includes diuretics, digoxin, calcium channel blockers, as well as anticoagulants (Chu and Selwyn, 2011).  Combination of antiretroviral therapy effects on the course of the disease including the prognosis of pulmonary hypertension is yet to be fully established.  Studies also indicate that HIV is known to accelerate emphysema-associated processes among smoker patients leading to the earlier and increased onset of COPD (Chu and Selwyn, 2011).

On the gastrointestinal system, HIV-related upper digestive issues including candidal infection, dysphagia, and odynophagia have been noted (Chu and Selwyn, 2011).  Related health issues include aphthous ulcers as well as oral ulcers from cytomegalovirus or herpes simplex virus for patients reaching CD4 counts of 200 per mm

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or less (Chu and Selwyn, 2011).  Diagnosing these diseases is possible through a histologic assessment following biopsy.  Routine tests for oropharyngeal cancer are important for HIV patients as this health issue is common among HIV patients (Chu and Selwyn, 2011).  Assessing gastrointestinal complications is mostly undertaken to measure immunosuppression and the quality as well as duration of symptoms (Carillo, Clotet, and Blanco, 2011).  Diarrhoea is one of the common afflictions among HIV patients with about 40% of patients reporting experiencing at least one episode of diarrhoea in the past month (Chu and Selwyn, 2011).  The virus attacks the intestinal cells and disrupts the motility of the gastrointestinal tract via the autonomic nervous system, causing HIV-associated enteropathy (Chu and Selwyn, 2011).  Inflammatory bowel disease occurs with increased frequency among individuals with HIV infection.

Summary

The immune system has a significant role in maintaining an individual’s health.  The body, specifically the white blood cells, undertake the necessary processes to prevent the body’s systems from being compromised by bacteria, viruses, as well as other sources of infection.  The immune system is more or less the body’s natural response to infection and even without medications, the immune system can prevent infections and ensure the well-being of the individual.  HIV-AIDS is an infection which attacks the body’s immune system, compromising its natural ability to fight off infection (Carillo, Clotet, and Blanco, 2011).  New strategies for prevention of the disease are mostly focused on health education in schools and in work places.  This also seems to include regular medical screening in work places in order to promote early detection and management (Carillo, Clotet, and Blanco, 2011).  New forms of treatment include immunology studies, primarily towards studying the behaviour of the virus and establishing how such behaviour can be delayed from progressing and how its impact on the individual can be reduced (Carillo, Clotet, and Blanco, 2011).  These are strong directions in treatment and management, but more studies are needed in order to secure improved patient outcomes.

References