Scenario I: Employment Law Smith filed suit- alleging her termination for stating that gays should not marry and will go to hell—a belief that she maintains is an aspect of her Apostolic Christian fai

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Scenario I: Employment Law

Smith filed suit, alleging her termination for stating that gays should not marry and will go to hell—a belief that she maintains is an aspect of her Apostolic Christian faith—constitutes unlawful discrimination under Title VII. Is she correct?

If Smith posted the same information on her Facebook page but omitted references to the specific employee, would the outcome of her lawsuit for wrongful termination change?

Fox Manufacturing is a small textile manufacturer using machine-hours as the single indirectcost rate to allocate manufacturing overhead costs to the…

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Fox Manufacturing is a small textile manufacturer using machine-hours as the single indirectcost rate to allocate manufacturing overhead costs to the various jobs contracted during the year. The following estimates are provided for the coming year for the company and for the Maize High School Science Olympiad Jacket job. Using the data, compute the estimated total manufacturing costs for the Maize High School job.

Cultural Analysis of Italy for the Healthcare Provider

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Italian Cultural Analysis

The Italian culture is as complexed as any other culture. The food alone is warm and comforting. These two things have interested me in researching and doing a cultural analysis on the Italian culture. Of what I have grown to think of the culture I admire the culture as a whole. As I know it they have close families, great food, great food traditions, and a positive view of life. This is what I hope to find during my analysis. The table below compares and contrasts the Italian culture as it is viewed in Italy and in the United States.


Key Point
Native Culture in Italy
Culture after U.S. Migration

Religion
 The Roman Catholic Church plays a major part in the way Italians walk through life and is the main religion in Italy. (Kittler, Sucher  & Nahikian-Nelms, 2017) After immigration the Roman catholic Church is viewed at differently and is found in separate “parishes” (Kittler et al., 2016). This is a separate church for each ethnic group. Some religious holidays are still celebrated. (Kittler et al., 2017)

Worldview (outlook on life)
 Based on views of family, church, and education an Italians worldview is focused on being self-reliant and upholding their families honor. The father is the head of the household, but the mother controls the day-to-day activities in the home. (Kittler et al., 2017) Still based on being self-reliant and upholding their families honor an Italian immigrant in the U.S. might view the world the same way, but it is all about the individual person. (Kittler et al., 2017)

Staple Foods
 

 

 

 


Staple Foods Continued

 Pasta, eggs, meats, cheese, vegetables (eggplant, artichokes, bell peppers, and tomatoes), butter, dairy products, rice, olive oil, fish, beans, garlic,  and spices (parsley, basil, oregano, anise, cinnamon, nutmeg, and cloves) are all staple ingredients in Italian foods. (Kittler et al., 2017) Not much will change as everything is easily found in America, but some American staples might be added. (Kittler et al., 2017)

Meal Patterns
 Light breakfasts are popular throughout Italy. Breakfast normally includes “coffee with milk, tea, or a chocolate drink, with bread and jam” (Kittler et al., 2017).Lunch is the biggest meal of the day and is known to be followed by a nap. Meal wise lunch consists of an appetizer course to start, “such as ham, sausages, pickled vegetables, and olives, or crostini” (Kittler et al., 2017). Then a “wet course” would be served such a soup or a “dry course” such as pasta (Kittler et al., 2017). The main course a dish with fish or meat “served with a starchy or green vegetable, followed by salad” (Kittler et al., 2017). Bread normally accompanies the meal.

“Dinner is served later in the evening around 7:30pm and is the lighter version of lunch” (Kittler et al., 2017). Wine is served during the meal and coffee after wards. (Kittler et al., 2017)

 Meal patterns might change to have the larger meal at dinner time instead of lunch. (Kittler et al., 2017)

Flavor Notes
 With the use of garlic, parsley, basil, oregano, anise, cinnamon, nutmeg, and cloves the flavor notes of Italian foods tend to be mild to bold in flavor. (Kittler et al., 2017) The flavor notes in the traditional foods stay the same. (Kittler et al., 2017)

Health Beliefs
 Common to American health beliefs Italian’s view their “well-being is defined as the ability to pursue normal, daily activities” (Kittler et al., 2017). A belief that fresh air is connected to ones well-being as well. Some believe in folk medicines. (Kittler et al., 2017) The fact that illness is due to contamination or heredity is believed by the Italian Americans. Though older immigrants fear that “drafts” (Kittler et al., 2017), hidden emotions and the supernatural might be the cause of illness. (Kittler et al., 2017)

Common Cooking /Preparation Methods
 Stews, baked dishes, roasted meats, grilled meats, and pan fried food items are popular cooking methods. (Kittler et al., 2017) Cooking methods don’t change from their Italian origins as they are close to the American’s cooking variations.(Kittler et al., 2017)

Health and Nutritional Concerns
 It is found that the Italians have a high intake of carbohydrates, low intake of fat with a high intake of monounsaturated fats compared to saturated fats. Obesity rate is at 45% in women and 66% in men. (Kittler et al., 2017) Less pasta and more meat are consumed meaning that the amount of saturated fats in the diet is increased and the carbohydrates might decrease from that of the Italian culture. (Kittler et al., 2017)

When counseling someone from the Italian culture there are a few things to keep in mind. “Italian Americans may seek medical advice from family and friends before consulting a health professional” (Kittler et al., 2017). It is known that when a Italian goes to seek help from a health professional they tend to be open and willing to explain their symptoms. (Kittler et al., 2017)

A healthcare provider should use respectful communication practices that are warm and empathetic. This entails that a conversational style that is “animated, warm, and expressive” (Kittler et al., 2017) should be used. “Shaking hands with everyone in the room in greeting and leaving is appropriate” (Kittler et al., 2017). Frequent and quick eye contact with elders and steady eye contact with younger Italians is preferred. (Kittler et al., 2017)

Dietary restrictions should be carefully explained as restriction recommendations may be disregarded when they don’t fit into normal social activity. This is a cause of concern for multiple chronic conditions such as diabetes. With a rise in obesity in the Italian culture this is an important factor to keep in mind when counseling.

If I were to Counsel someone from the Italian culture, I would keep the above in mind. Always greet the client with a smile and a hand shake. Keep steady eye contact and listen to all that they are concerned about health wise. I would make sure that my body language shows that I care about their well-being. If possible I would try and educate the family as well as the client because family tends to play a big role in an Italians life. For dietary restrictions I would carefully educate and motivate the client to make healthier choices and if they interfere with their normal social activities. I will counsel them on why the restrictions should not be ignored. Respectfully my communication practices should be viewed as warm and empathetic.

Healthy People 2020 has a vision of “a society in which all people live long, healthy lives” (Healthy people 2020, 2019).  Their mission is to-

“identify nationwide health improvement priorities, increase  public  awareness  and  understanding  of  the  determinants  of  health,  disease,  and  disability,  and  the opportunities for progress, provide measurable objectives and goals that are applicable at the national, state, and local levels, engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge, and identify critical research, evaluation, and data collection needs” (Healthy people 2020, 2019).

Healthy People 2020 has 42 topic areas of concern that is tracked and examined with a goal of limiting them across the country (Healthy people 2020, 2019). The Italian culture will benefit from this by the goals of lowering obesity and other chronic conditions such as diabetes.

Another program that improves the health of the Italian American culture would be the Obesity Society. Their vision is for a “better understand, prevent and treat obesity to improve the lives of those affected through research, education and advocacy” (obesity.org). Their mission statement is “Through TOS’s (The Obesity Society) unique position, lead the charge in advancing the science-based understanding of the causes, consequences, prevention and treatment of obesity” (obesity.org). The Obesity Society is a great public health program for the Italian American culture as obesity shows up in 45% of women and 66% of men throughout the culture.

Throughout this paper I have found that though it is easy to generalize a culture in to stereotypes with the Italian culture I found that there is diversity within the culture that is found in every other culture. I have learned that the rich food culture that is heavy in carbohydrates can lead to health concerns throughout the culture. I enjoyed this cultural analysis because I got to research and learn about someone else’s culture in-depth and determine a way that I would be able to counsel them. It has been interesting and informative for me.


References

  • Healthy people 2020. (2010, November). Retrieved August 4, 2019, from https://twu.blackboard.com/bbcswebdav/pid-4576076-dt-content-rid-117317307_1/courses/17FANFS317351/HP2020_brochure_with_LHI_508_FNL.pdf
  • Kittler, P. G., Sucher, K. P., & Nahikian-Nelms, M. (2017). Food and culture (7th ed.). Boston, MA: Cengage Learning.
  • About Us. (n.d.). Retrieved August 4, 2019, from https://www.obesity.org/about-us/

Multiple Sclerosis (MS): Epidemiology- Genetics and Causes

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Intro

Multiple Sclerosis (MS) is a neurological disease that affects the brain and spinal cord. This occurs because of damage to the outer layer of nerve called the myelin sheath. An autoimmune response occurs, and the body attacks part of the nerve called the myelin sheath, “immune cells, which normally defend the body against bacteria and viruses, mistakenly attack the myelin sheath, stripping it away and exposing the nerve fibers underneath” (“Myelin: An Overview”, 2015). Nerves are little communication sources directed by the brain that tell muscles what to do. Once the damage occurs from MS miscommunication between the brain and muscles occur (“Myelin: An Overview”, 2015). Nerves are not controlled properly by the brain and symptoms can be different from person to person (“Myelin: An Overview”, 2015). The full spectrum of the disease multiple sclerosis is still not completely understood. However, over the last few centuries physicians and experts have learned a lot when it comes to: history, epidemiology, diagnosis, abnormal pathophysiology caused by the disease, treatment, effects on other organs, the different stages of the disease, and the role genetics play.


History

Due to the difficult nature of identifying and diagnosing multiple sclerosis wasn’t given a name until 1868 (“History of Multiple Sclerosis”). Jean-Martin Charcot was the neurologist to do this in and he is often called “the father of neurology” (“The History of Multiple Sclerosis”, 2016). This physician kept close detail of the patient’s symptoms and signs of the disorder (“The History of Multiple Sclerosis”, 2016). Experts today can look back at his notes and confirm Charcot’s diagnosis of MS. Charcot’s early attempts to treat MS were unsuccessful. Examples of therapies tried were: deadly nightshade, arsenic, mercury, and injection of malaria parasites (“History of Multiple Sclerosis”). Charcot was frustrated due to the inability to cure the disease (“The History of Multiple Sclerosis”, 2016). Once he examined the deceased patients brain he noticed the scars on it from MS (“The History of Multiple Sclerosis”, 2016). In the 19

th

century physicians around the world recognized MS as a disease, “MS was recognized in the England by Dr. Walter Moxon in 1873, and in the United States by Dr. Edward Seguin in 1878” (“The History of Multiple Sclerosis”, 2016).  The knowledge of MS grew vast at the end of the century. Physicians were able to recognize common traits of MS like age and heredity or the neurological symptoms people experience (“The History of Multiple Sclerosis”, 2016). Throughout the years physicians and other experts have learned more about MS because the expansion of knowledge in bacteria, viruses, and diseases in general (“The History of Multiple Sclerosis”, 2016). This makes a lot of sense because over time resources and technology have also developed as useful tools in the expansion in knowledge of MS. Key components of understanding MS biologically were discovered like myelin in 1878 and the cells that make up myelin in 1928 (“The History of Multiple Sclerosis”, 2016). Spinal fluid abnormalities that help physician’s diagnosis patients with MS were discovered in 1919(“The History of Multiple Sclerosis”, 2016). In 1951, the first therapy was found to reduce the harshness of relapses; as well as, shortening them was cortisone (“History of Multiple Sclerosis”).


Epidemiology

There has been a lot of data collected comparing types of individuals who have or get MS more frequently. Factors like gender, age, race, and hereditary all are risk factors to developing the disease.  Young adult females are more likely get the disease, “Multiple sclerosis favors women over men by a ratio of nearly 2 to 1 and strikes most often between the ages of 20 and 40” (Rolak, 2003, p.57). There is also a trend of Caucasians who live in northern European countries developing MS (Rolak, 2003, p.57). If a family member has the disease it may put others at risk in that family as well, “…MS tends to cluster slightly within families, as there is a 1 to 5% risk of developing MS if a parent or sibling has the disease, and at least 25% concordance among monozygotic” (Rolak, 2003, p.57).


Genetics

Multiple Sclerosis is not an inherited disease. This means the disease itself is not passed on to future generations; however, factors that possibly puts individuals at risk are (“What Causes MS?”). The National Multiple Sclerosis Society discusses peoples risk of developing the disease, “In the general population, the risk of developing MS is about 750-  1000 people” (“What Causes MS?”). If a relative in the imitate family has MS it can put that individual at higher risk and having an identical twin with MS can make this risk even greater (“What Causes MS?”). There are about 200 genes who have been identified that they each may be a small contributing factor (“What Causes MS?”). According to the genetic home reference about MS from U.S National Library of Medicine HLA-DRB1 and IL7R are two genes linked to MS when there are gene abnormalities (“Multiple sclerosis – Genetics Home Reference – NIH”, 2019). The family of HLA-DrB1 is called the human leukocyte antigen (HLS) complex. This group helps the body differentiate proteins made an individual’s own body and external intruders (“Multiple sclerosis – Genetics Home Reference – NIH”, 2019). The IL7R gene has a special role in the immune system, “… provides instructions for making one piece of two different receptor proteins: the interleukin 7 (IL-7) receptor and the thymic lymphopoietin (TSLP) receptor” (“Multiple sclerosis – Genetics Home Reference – NIH”, 2019). The two different receptors live in the cell membrane and there signaling pathways encourage development and existence of immune cells (“Multiple sclerosis – Genetics Home Reference – NIH”, 2019). A patient with MS has the gene IL7R (IL-7) receptor living inside the cell instead of the cell membrane. Both of the genes affect the immune system, so any variance in the genes could potentially set off an autoimmune response. (“Multiple sclerosis – Genetics Home Reference – NIH”, 2019). The symptoms related to MS are caused by an autoimmune response that damages the protective layer of a nerve called the myelin sheath.


Paragraph 4: Cool Discoveries


Environmental Factors

While researching multiple sclerosis I was surprised to see possible environmental factors that could put one at risk of developing MS. I had no previous knowledge of what could possibly put one at risk to developing MS besides abnormalities in one’s genes. Some of the possible environmental risk factors include low vitamin D levels, smoking, and obesity. A lot of articles and websites discussed the types of people at greater risk of developing MS. There is evidence proposing individuals who live closer to the equator that have more sun exposure and higher Vitamin D levels are at lower risk of developing MS (“What Causes MS?”). The belief behind this is that higher levels promote healthier immune function. This may protect people living in higher sun exposer areas from the autoimmune responses MS has (“What Causes MS?”).  Other studies suggest individuals who suffer from MS could benefit from vitamin D. Increasing the vitamin level could possibly lessen the occurrence and harshness of symptoms; as well as, lengthening the time between relapsing- remitting MS and secondary-progressive MS (Collazo, 2019). The authors from the article, “Vitamin D and Multiple Sclerosis: A Comprehensive Review” mention there is a correlation between people who have low vitamin D levels and MS; however, others that suffer from MS with low levels may benefit from taking vitamin D supplements (Sintzel, Rametta, & Reder, 2017, p.81).  Smoking not only increases a person’s risk of developing MS but it can also make the progression of MS happen faster (“What Causes MS?”).


Paragraph 5: Normal/abnormal patho phys of tissue/ structures


Diagnosis/test ordered

Multiple Sclerosis (MS) can be challenging to diagnose. This occurs because there is not specific test to tell physicians if patient has MS like other diseases. A lot of symptoms of MS are also signs for other diseases and disorders making it even more difficult to diagnosis. Different test and imaging must occur as well as differential diagnosing before a physician can make diagnosis of MS. A physician will get all the patient’s history of “any past or present symptoms that might be caused by MS” (“Diagnosing MS”). The health care professional will also look at environmental factors, family history, birth place and places traveled (“Diagnosing MS”). This information may give the doctor clues on other diseases or disorder causing the symptoms. They also look for patterns in reoccurring of symptoms, possible remissions, or flare ups that may suggest MS. Next, a physician will perform a neurological exam, “which includes test of cranial nerves (vision, hearing, facial sensation, strength, swallowing), sensation, reflexes, coordination, walking and balance” (“Diagnosing MS”). A neurological exam usually provides enough evidence to make a diagnosis, but other test is used to confirm a diagnosis of MS (“Diagnosing MS”). Blood test are usually where most physicians start after medical history to help rule out other diseases. There are specific biomarkers associated with MS that blood test can check for (“Multiple Sclerosis”, 2019). Abnormal antibodies can also be linked to MS (“Multiple Sclerosis”, 2019). Physicians may order a lumbar puncture where they remove a small amount of spinal fluid from the spinal canal (“Multiple Sclerosis”, 2019). The laboratory will test the fluid for related antibodies; as well as, ruling out other infections or conditions with similar symptoms (“Multiple Sclerosis”, 2019). In the active phase of MS, lesions can appear on the brain or spinal cord (“Multiple Sclerosis”, 2019). A magnetic resonance image (MRI) can show enhanced imaging of the brain and spinal cord to reveal any lesions that may be on them (“Multiple Sclerosis”, 2019). Nerve endings can be damaged or destroyed because of MS. Another tool physicians can use to diagnosis MS is through evoked potential tests. This test consists of, “electrical signals produced by your nervous system in response by your nervous system in response to stimuli” (“Multiple Sclerosis”, 2019). Physicians want to see how the rate information travels to the nerve pathways (“Multiple Sclerosis”, 2019). The National Multiple Sclerosis Society discusses the reality of diagnosing a patient with MS, “At this time, there are no symptoms, physical findings or laboratory test that can, by themselves, determine if you have MS (“Diagnosing MS”). Test like spinal fluid analysis, blood analysis, or evoked potentials need more research to directly diagnosis MS; however, are good tools to lead to a diagnosis of MS (“Diagnosing MS”). To diagnoses a patient with MS physicians must rule out other possible diseases or disorders with similar symptoms, which is called differential diagnosing.


Paragraph 7: can cause other health issues/ mental health


Treatment: medication and rehabilitation therapy

There are many different stages and options when dealing with treatment for multiple sclerosis(MS); however, MS has no cure. The National Multiple Sclerosis Society breaks down the treatment of MS in a comprehensive approach, which includes: “modifying the disease course, treating exacerbations, managing symptoms, promoting function through rehabilitation, providing emotional support” (“Comprehensive Care”). First, is altering the disease course with medication. There are three types of possible medication therapies approved by the U.S Food and Drug Administration (FDA) to treat relapsing forms of MS which include injectable medications, oral medications, and infused medications (“Comprehensive Care”). One medication has been approved to treat relapsing MS and primary-progressive MS, while various others are approved to treat secondary progressive MS (“Comprehensive Care”). The possible outcomes from medication therapies are the reduction in the number and harshness of relapses, the reduction of lesions in the brain or spinal cord, and the possible reduction of overall speed of the disease (“Comprehensive Care”). Relapses are sometimes called exacerbations, and this is caused by inflammation in the central nervous system. Medication therapy is a resource a patient may be able to use to control exacerbations (“Comprehensive Care”). All drugs have side effects, and this is no different when discussing drugs used to modify progression of MS. For the reason, physicians discuss with patients their best options based on cost, type of MS, side effects, life style. According to the Multiple Sclerosis Association of America the severity of the medication given may change the effectiveness but may be a potential health risk, “Stronger drugs may offer greater effectiveness but may also pose greater health risk” (“Long-Term Treatments for Multiple Sclerosis”). There are other treatments for the signs and symptoms of MS.

Physical therapy is an effective way to improve overall daily functions when dealing with MS. It teaches patients how to stretch and strengthen muscles, which can help with total fitness and energy (“Comprehensive Care”). A lot of people who suffer from MS also experience fatigue. One way to reduce fatigue is to build up endurance. Patients can build up endurance through exercise. Rehabilitation works with patients who have MS to either progress or preserve functions at home or work (“Comprehensive Care”). Therapist work on task one needs to live everyday life. Sometimes MS patients need help walking because of nerve damage and muscles are no longer receiving the correct messages from the CNS (“Functional Electrical Stimulation (FES)”). There may be braces patients wear to keep muscles working in specific ways (“Functional Electrical Stimulation (FES)”).  Functional Electrical Stimulation can be used instead of braces depending on severity of nerve damage and best interest of patient. This device works by sending low level electrical impulses to nerves (“Functional Electrical Stimulation (FES)”). In this example the nerves would signal the leg to pick up the foot. Studies do note FES it may not help everyone in this way and it can be expensive (“Functional Electrical Stimulation (FES)”). There are other possible treatments to manage pain or symptoms for patients diagnosed with MS. Some patients try chiropractic therapy reducing irritation in nerves, marijuana for pain relief, massage for improvement in mood, acupuncture for anxiety or depression, and naltrexone (in small doses) for pain relief (“Comprehensive Care”). In MS it is common to see depression, anxiety and other mood changes (“Comprehensive Care”).  Mental health is also a part of the treatment process. Addressing mental health issues are hard; however, imperative to patients’ health. Things like acupuncture, massages, family and friend support, or even speaking with a psychiatrist may be helpful ways to improve mental health.


Different forms of MS

Multiple Sclerosis comes in different forms which include: relapsing- remitting MS, secondary progressive MS, primary progressive MS, and progressive relapsing MS. Relapsing- remitting MS is most commonly seen, “…which affects approximately 80 percent of people with multiple sclerosis” (“Multiple sclerosis – Genetics Home Reference – NIH”, 2019).  During this form of MS individuals have periods of time where symptoms are active and then will go into periods of times called remission (“Multiple sclerosis – Genetics Home Reference – NIH”, 2019). When patients experience remission, they do not experience symptoms. There is no known explanation for why people experience triggers (cause to experience symptoms) or remission (“Multiple sclerosis – Genetics Home Reference – NIH”, 2019). Secondary progressive MS is a form of MS that usually people with relapsing-remitting MS experience after an amount of time (“Multiple sclerosis – Genetics Home Reference – NIH”, 2019). During secondary progressive MS individual’s symptoms worsen and do not experience remission (“Multiple sclerosis – Genetics Home Reference – NIH”, 2019). Primary progressive MS is seen in ages forty and up. This type of MS has worsening symptoms overtime, but people do not experience triggers or remissions (“Multiple sclerosis – Genetics Home Reference – NIH”, 2019). The last form of MS is progressive relapsing MS and it is very similar to primary progressive MS; however, an individual would experience symptoms constantly and more severely (“Multiple sclerosis – Genetics Home Reference – NIH”, 2019).


Prognosis

Multiple Sclerosis is not often terminal. There can be a huge impact on quality of life and possible disabilities. However, due to the advances in therapies patients are not helpless. In the article, “Multiple Sclerosis: It’s Not The Disease You Thought It Was” by Loren A. Rolak a good portion of patients can live relatively normal life. Rolak describes this by saying, “…but fully 60% will be ambulatory without assistance and some will have little deficit at all” (Rolak, 2003, p.58). With medication and rehabilitation patients can fight the preconceived notion the public has of MS.


Paragraph 10: reflection


Works Cited

  • Diagnosing MS. (n.d.). Retrieved May 7, 2019, from

    https://www.nationalmssociety.org/Symptoms-Diagnosis/Diagnosing-MS
  • Collazo, I. M. (2019, February 09). This vitamin might lessen the severity of MS symptoms. Retrieved May 9, 2019, from https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/expert-answers/vitamin-d-and-ms/faq-20058258
  • Comprehensive Care. (n.d.). Retrieved May 7, 2019, from https://www.nationalmssociety.org/Treating-MS/Comprehensive-Care
  • Functional Electrical Stimulation (FES). (n.d.). Retrieved May 7, 2019, from

    https://www.nationalmssociety.org/Treating-MS/Rehabilitation/Functional-Electrical-Stimulation-(FES)
  • Long-Term Treatments for Multiple Sclerosis. (n.d.). Retrieved May 7, 2019, from

    https://mymsaa.org/ms-information/treatments/long-term/
  • History of Multiple Sclerosis. (n.d.). Retrieved May 7, 2019, from https://mymsaa.org/ms-information/overview/history/
  • Multiple Sclerosis | MS. (2019, February 07). Retrieved May 8, 2019, from https://medlineplus.gov/multiplesclerosis.html
  • Multiple sclerosis. (2019, April 19). Retrieved May 7, 2019, from

    https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/diagnosis-treatment/drc-20350274
  • Multiple sclerosis – Genetics Home Reference – NIH. (2019, April 30). Retrieved May 9, 2019, from https://ghr.nlm.nih.gov/condition/multiple-sclerosis#genes
  • Myelin: An Overview. (2015, March 24). Retrieved May 8, 2019, from http://www.brainfacts.org/Brain-Anatomy-and-Function/Anatomy/2015/Myelin
  • Rolak, L. (2003) Multiple Sclerosis: It’s Not The Disease You Thought It Was.

    Clinical Medicine & Research, 1

    (1), pp. 57-60.
  • Sintzel, M. B., Rametta, M., & Reder, A. T. (2017). Vitamin D and Multiple Sclerosis: A Comprehensive Review.

    Neurology and therapy

    ,

    7

    (1), 59–85. doi:10.1007/s40120-017-0086-4

  • The History of Multiple Sclerosis

    [Brochure]. (2016). Retrieved May 8, 2019, from https://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Brochures/Brochure-History-of-Multiple-Sclerosis.pdf
  • What Causes MS? (n.d.). Retrieved May 9, 2019, from https://www.nationalmssociety.org/What-is-MS/What-Causes-MS

Tuberculosis in Homeless Poplulation

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Tuberculosis in Homeless Poplulation

Subject: Nursing
*Topic: Tuberculosis in the Homeless Population

*Develop a simple teaching plan to the homeless population in Los Angeles and Orange County Area.
1)Access to health care service for the homeless population with tuberculosis in the Los Angeles and Orange County Area.

2)The role of the public health nurse in a Tuberculosis Clinic for primary, secondary and tertiary prevntion on homeless population with tuberculosis.

3) Treatment regimen include:
-(4) types of TB medication
(include compliance and how/when it should
be taken)
-Any other treatment for tuberculosis patient.

4)Maintenance plan:
-Follow-up with public health department or
doctor.
-Where to follow-up if person has no insurance.

5)Future prevention techniques
-How to prevent the spread of TB.
-Techniques of avoiding exposure.
-Teaching in prevention and exposure.

6)Include (4) Resources available in the Los Angeles and Orange County are in the United States.

7)Include (4) hotline and reporting agencies phone numbers.

PLEASE USE INFORMATION FROM THE

-Centers of Disease Control (CDC)
-World Health Organization (WHO)
-Department of Health
-Orange County Public Health TB Clinic
( https://ochealthinfo.com/phs/about/dcepi/tb/faq#1349 )

Describe any challenges you have faced personally, financially, or academically that you have had to overcome. How have you dealt with the challenges you have faced? How have these barriers or your success in overcoming challenges affected your goals and personal character?

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Describe any challenges you have faced personally, financially, or academically that you have had to overcome. How have you dealt with the challenges you have faced? How have these barriers or your success in overcoming challenges affected your goals and personal character?

 

Scholarship Essay

Background: My parents both immigrated from Vietnam. I am a first generation college student in my family as I was born in the USA. I do not have any siblings nor work experience. I am from a low-income family so I rely on grants and scholarships along with financial aid to pay for my tuition. Previously, I was a freshman at a community college with a major in Health & Medical Services. I maintained a good GPA throughout the first year by making the Dean’s List and was a Historian in the Science Interest Group by spearheading events/club activities to promote awareness and knowledge among students with professional guest speakers. I transferred to a University in my hometown the following year. I am currently a sophomore with a major in Human Nutritional/ Pre-Medical Science. (The B.S. in Human Nutrition and Foods (Nutritional Sciences Track) is a pre-professional degree plan designated to meet the requirements for pre-med, dental, optometry and other post-graduate programs in the health care area.) In the past, I had volunteered at a public library for three years. I utilized my Vietnamese skills, designed seasonal programs for library events, and checked bookshelves to verify orderly placement. I am also an adult volunteer at a hospital in the Human Resources department. I collaborate with the HR Coordinator and hospital departments with clerical duties and complied orientation paperwork and employee records. I am part of Delta Omega Chi (DOC), a medical service society that benefits underprivileged and undeserved areas in health care and Health Occupations Students of America (HOSA).

PROMPT 1: In 500 words, please describe your short-term and long-term personal and education/career goals and what has helped to shape your goals. What specific steps will you take to reach your personal/education/career goals?

**Please DO NOT copy and paste the following into the essay. If you need to, please consider paraphrasing.**

Inspiration: I’ve always had a passion helping my parents with chores and the reward of helping someone else had touched my heart. I knew I wanted to become a doctor ever since because of the rewarded feeling of helping a person in need. I’ve also grown up alongside my baby cousin who was born with Down Syndrome. I’ve seen what incredible things the people at the hospital do for their patients and families each and everyday which had also inspire me. [Feel free to incorporate this and elaborate more into the essay if necessary]

Short term goals: Maintain a good GPA throughout nutritional and pre-medical courses. To participate in an internship at a local clinic or hospital. To also work with researchers in the nutritional sciences department and assist with ongoing research projects. To get accepted into medical school. Will be participating in Health Occupations Students of America (HOSA) ‘s health science events.

Long-term goals: Applying to medical school while receiving bachelor’s degree (B.S) in Human Nutrition. Becoming a medical physician, specifically a Pediatrician, and serve under-privileged communities/ developing countries.
PROMPT 2: In 500 words, please describe how you plan to give back to your community and help fulfill the needs of your community after you’ve completed your education. How would your plan impact not only your immediate community, but also a broader one?

Intentions: Alter the rumors that arises from the lower class about medical services in developing countries, especially Vietnam. Incorporate how I can use my nutrition knowledge and skills as a pediatrician. Promote nutritional awareness.Provide free healthcare services. Protect health interests of children. Give back to the community. Feel free to incorporate other ideas that may help support my determination.

PROMPT 3: In 500 words, please describe any challenges you have faced personally, financially, or academically that you have had to overcome. How have you dealt with the challenges you have faced? How have these barriers or your success in overcoming challenges affected your goals and personal character?

Palliative Care for Cancer Patients | Literature Review

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  • Gretha Cabral


Literature Review

Cancer has become a global concern in the recent decades and various researches have raised the need for palliative care for cancer patients besides the treatment that they receive from their respective hospitals. Researches show that palliative care prolongs the life of patients more as compared on relying the treatments alone. According to research conducted by Julia Medew, patients who are suffering from lung cancer could enjoy longer, quality life and low depression where they bestowed palliative care immediately after they are diagnosed with lung cancer, as opposed to starting at the late stages of the disease. According to this study, Medew aimed that; the findings would change the views of both the patients and the doctors on the quality of palliative care (Medew, 2011). The care aims at improving the quality of life of the for patients with progressive, serious illnesses through paying high attention to the control of their symptoms and pain, recognizing their spiritual and psychological needs and providing the necessary support to the patients and their families.

Medew`s study divided 151 patients with lung cancer into two groups in order to clearly outline the quality of palliative care (Medew, 2011). The first group of lung cancer patients was to solely rely on the standard treatment that the patients would receive from the health facilities while the second group was to receive the same treatment that would be accompanied by immediate referral to palliative care within a time range of twelve weeks after diagnose. Consequently, the findings showed that, the average survival period of patients in the second group was around three months longer and those patients reported living a high quality life and far much better moods as compared to the first group.

Moreover, this American study was seconded by Ian Haines, who was a Melbourne cancer specialist who recommended that, palliative care should be administered by doctors to cancer patients. This suggestion was made because most health professionals, cancer patients and many other individuals realized that palliative care can serve as the only default measure of managing cancer when all other measures have been exhausted. He also suggested that, if early referral of cancer patients to professional palliative care can be an expensive measure, the governments should subsidize by increasing the allocation of more funds to the ministry of health since its value outweighs the costs that may be associated with it (Medew, 2011).

Professor Haines also gave another case study that recently followed 333 cancer patients up to their death. The study also divided the patients into groups where one involved patients who were hospitalized to receive cancer treatments while the other group was treated and discharged in order to receive additional palliative care at their respective homes. The study findings showed that, patients in the first group died within a short time interval than those in the second group. In addition, those patients in the first group also experienced emotional and physical distress than those patients in the second group who died while receiving palliative care at their homes. The study concluded that, faster occurrence of deaths in patients who are admitted in health facilities was highly contributed by high extents of grief and more post-traumatic stress that arose from the family members and friends of those patients (Medew, 2011). His study also established that early referral of patients to palliative care helps caregivers and patients to understand their treatment options better especially at the end of their life. Furthermore, this early referral helps to reduce debilitating expensive treatments such as chemotherapy and excessive utilization of limited medical resources.

In addition, most cancer patients are not used to palliative care in most countries and this unfamiliarity calls for the need for providing information to patients, their family members and friends sensitizing to them the quality of palliative care. According to research conducted by Ms. Etheredge, one of the officials of hospice palliative care society, she found that, palliative care frightens most individuals including cancer patients since most people are used to the tradition of patients being admitted to hospitals for treatment. Therefore, discharging cancer patients after treating them and then requiring them to seek palliative care at their respective homes elevate stress to patients since the latter concludes that they are being sent to meet their deaths at home. She suggested that, the governments should construct a cancer hospice in a strategic point since according to her, the environment where palliative care is provided matters most (Furse, 1999). She further suggested that, any other hospice to be constructed near to water and bus route since these are the two primary necessities that assist the caregivers and the families.

Moreover, she also seconded the decision of the health minister of Australia in launching the national palliative care awareness week that would inform people about the equity and access of this care (Brigid, 2011). During the launching of this palliative care awareness campaign, the health minister also outlined the palliative strategic plan to inform the services that palliative care offers. In addition, brochures printed in Greek, Chinese, Vietnamese, Italian and polishes were distributed to different people during that week outlining palliative care services. This distribution of brochures was to enhance the reach of palliative care information to more people especially those who both don’t speak English and are not aware of the services provided by palliative care.

In addition, according to Mark Colvin, most of the cancer patients in Australia are not aware of the existence, quality and the services that are provided by palliative care centers because most doctors do not sensitize and refer these patients to palliative services. According to study that surveyed a sample of one thousand doctors all over the country and within the duration of one year, more than eight hundred doctors do not refer cancer patients to palliative care. Merrilyn stone, for example, was not referred to palliative care when she was initially diagnosed with breast cancer in 1990 (Barrett, 2004). This lack of referent made her to still firm her believe that palliative care is intended for the dying people and this made it harder for her to understand the value of palliative care when her condition came back eleven years later.

Moreover, according to Afaf Girgis, this lack of referring patients to palliative care during the early stages of cancer development enhances the perception of the community and the patients that palliative care is intended for individuals who are at the death`s door and this is much untrue. Girgis further outlines this lack of referring cancer patients to palliative care predisposes the patient to more and severe consequences when the disease progresses to its advanced stages. In the long run, the particular patients live less additional days, as opposed to when they would have been early referred to palliative care services (Barrett, 2004).

However, according to Rebecca Barrett, the study found that, very few health professionals who used to refer their patients to palliative care. In addition, in case these health professionals happen to refer cancer patients to palliative care, the latter was mostly intended to control pain but not for emotional or psychological support or legal and financial support. Consecutively, according to Dr. Sundquist, most health professionals concentrate more on curing the cancer patients and most are unaware of the quality of palliative care. He further challenges this doctors` works and suggests that, the latter needs to understand more is needed to cancer patients besides treatment services (Barrett, 2004). Moreover, cancer patients need additional services that include practical and emotional support that involves palliative care.

Moreover, in Australia, Whyalla hospital developed project of constructing Whyalla cancer treatment Centre that would cancer services almost at par with the same treatment services that were offered in Adelaide. Initially, many cancer patients were forced to travel long distances in order to access cancer services at Adelaide hospital (Bruce, 2012). The construction of Whyalla cancer Centre aimed at reducing the transportation burden of cancer patients to long distances. According to whale news, the cancer center would offer a wide range of palliative services to the cancer patients especially those who were recently diagnosed with cancer. According to the chairman of his cancer project Mr. champion, the cancer Centre would offer services such as creating space for training activities and research, counseling of cancer patients, chemotherapy, outpatient care services among others. Additionally, the Whyalla cancer Centre would operate in cooperation with the already established Adelaide health facility in order to share health professionals and other technical equipments. This cooperation statement was echoed by Mr. Champion who said “the specialists will determine if the complexity of the cancer requires the patient to receive treatment in Adelaide or if they can remain in Whyalla.” (Bruce, 2012)

However, the recent researches show that most patients suffering from cancer would prefer to meet their deaths at their homes rather than at the health facilities. These researches recommend that health professionals should follow the wishes of cancer patients on where the latter wants to receive palliative care. In connection to this, Eurobodalla health services have provided ambulance protocols that would facilitate doctors to respond to the emergency calls from the homes of cancer patients (Oconnor, 2014). These services would enable cancer patients to receive palliative care at their homes as they wish.

References

Barrett, R. (2004).

Cancer patients missing out on palliative care; palliative support

. Sydney, Australian Broadcasting Corporation. ABC Premium News Retrieved from

http://search.proquest.com/docview/458087832?

Brigid, O. (2011).

Palliative care boosted

. Melbourne, News Digital Media. Vic.Sunday Herald – Sun Retrieved from

http://search.proquest.com/docview/867896592?

Bruce, K. (2012).

Good news for cancer patients

. Whyalla, S. Aust, Fairfax Media Publications Pty Limited. Whyalla News Retrieved from

http://search.proquest.com/docview/1081480966?

Furse, L. (1999).

Strategy for better palliative care

. Canberra, A.C.T, Fairfax Media Publications Pty Limited. Retrieved from

http://search.proquest.com/docview/1012751431?

Medew, J. (2011).

Early palliative care could prolong life

. Canberra, A.C.T, Fairfax Media Publications Pty Limited. Retrieved from

http://search.proquest.com/docview/1020447587?

Medew, J. (2011).

Palliative care extends length and quality of life

. Sydney, N.S.W., Fairfax Digital. Sydney Morning Herald Retrieved from

http://search.proquest.com/docview/854392582?

Oconnor, K. (2014).

Treatment available closer to home for palliative patients

. Batemans Bay, N.S.W, Fairfax Media Publications Pty Limited. Bay Post Retrieved from

http://search.proquest.com/docview/1516592167?

Gretha Cabral s3483440

This student written literature review is published as an example. See

How to Write a Literature Review

on our sister site UKDiss.com for a writing guide.

Advocacy plays an important role in the case management process. Case managers advocate for optimal conditions to help clients successfully reach their goals. Unfortunately, case managers cannot control all elements of the communities in which clients live. For example, suppose a case manager takes on an alcoholic client who is new to recovery.

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Advocacy plays an important role in the case management process. Case managers advocate for optimal conditions to help clients successfully reach their goals. Unfortunately, case managers cannot control all elements of the communities in which clients live. For example, suppose a case manager takes on an alcoholic client who is new to recovery.

The client happens to live in a community where liquor stores outnumber supermarkets. The case manager cannot change the situation, and so might instead choose to look for strategies to help the client better approach it. When case managers assess and address challenges that arise in communities, the advocacy role evolves into active support on behalf of their clients.

For this Assignment, imagine that your client lives in your community. To complete the Assignment, assess your community and identify challenges that may affect your ability to advocate on behalf of your client.

Consider the needs faced by the community in which you live, and imagine each of your clients as a community member there.

Review Chapter 7, “Additional Components of Case Management Intervention and Evaluation” from the Course Text. Consider the relationship between the responsibilities described and the advocacy role.

Review the article, “Skills and Knowledge Needed to Practise as a Care Manager: Continuity and Change.” Consider the role of the skills described in terms of case managers’ ability to advocate for clients.

Review the article, “Helping Older People Experience Success: An Integrated Model of Psychosocial Rehabilitation and Health Care Management for Older Adults with Serious Mental Illness.” Consider the needs of the population described.

Review the code of ethics of the National Organization of Human Services. Think about the qualities of the various responsibilities outlined.

Review the virtual client selected for the Discussion and how you might advocate for that client.

Imagine your virtual client lives in your community. Consider challenges within your community that may affect how you advocate for your virtual client. Consider how you might address each challenge.

Classifying database technologies and systems | CM220M2 Constructing Logical Arguments Update alerts – You have new alerts

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HI300-2: Classify database technologies and healthcare information systems used to manage data and information.

PC 3.2: Interact with others in a professional manner using appropriate communication and presentation skills.

Information Governance Considerations within a Healthcare Setting

Please complete all parts in a Microsoft Word document.

Assignment Requirements

The body of your document should be at least 1000 words in length.

Quoting should be less than 10% of the entire paper. Paraphrasing is necessary.

Students must cite and reference at least 4 credible sources from the Library.

Visit the Academic Success Center: Writing Center to assist you with meeting APA expectations for written assignments.

Instructions

Imagine that you are the Director of Health Information for a large hospital. As Director, you sit on various institution-wide committees which govern the organization’s policies. You have seen issues arise that cause you to propose changes in policies, procedures and operations across the hospital. Therefore, you have decided

to create a proposal to the CEO and Board of Directors, which you will develop in collaboration with committee teams. Please follow the instructions below in completion of this assignment.

Part

Instructions

1

Select two (2) applications/systems for clinical classification and coding (e.g., encoders, computer assisted coding (CAC), etc.) and appraise each vendor in terms of (1) capacity to evaluate quality coding practices, (2) possible implementation considerations/issues, and (3) systems management challenges and training needs. Provide support for one system that you find as the “best option” with rationale.

2

Consider the principles and applications of classification systems (e.g., ICD-10, HCPCS) and medical record auditing used within a clinical documentation improvement (CDI) program. Appraise the value and challenges of a quality CDI program by defending the need for ongoing CDI program support and critique at least two (2) challenges in the CDI process. Make connections between auditing, accurate diagnostic and procedural coding with classification systems, and CDI programs. Your executive summary should reflect upon the need for CDI and best practices for ensuring compliance.

3

Critique one interoperability issue that is possible within the health information exchange (HIE) (e.g., patient identity matching). Appraise at least two (2) best practices that address the issue.

4

Evaluate at least two (2) health information systems (HIS) and two (2) data storage designs (e.g., onsite, cloud). Select the best HIS and data storage design for disaster recovery purposes. Indicate your selections with rationale.

5

Evaluate at least two (2) managerial challenges related to clinical indices, databases, and registries from the perspective of a hospital’s health information management function. Recommend at least two (2) best practices or policies related to the management of secondary data sources.

6

With respect to data warehousing, appraise at least two (2) approaches in data warehouse design that supports quality data management from varying sources, processing/storage of data throughout the warehouse model, and meaningful output into the presentation layer. Summarize your recommendations in the executive summary.

7

Analyze data and information from the point of creation or collection, through the management, storage, and transformation into information and duration of its required retention period.

Minimum Submission Requirements

This Assessment should be a Microsoft Word document (minimum 1200 words), including a title and reference pages.

Respond to the questions in a thorough manner, providing specific examples of concepts, topics, definitions, and other elements asked for in the questions. Your submission should be highly organized, logical, and focused.

Your submission must be written in Standard English and demonstrate exceptional content, organization, style, and grammar and mechanics.

Your submission should provide a clearly established and sustained viewpoint and purpose.

Your writing should be well ordered, logical and unified, as well as original and insightful.

A separate page at the end of your submission should contain a list of references, in APA format. Use your textbook, the Library, and the internet for research.

Be sure to cite both in-text and reference list citations where appropriate and reference all sources. Your sources and content should follow proper APA citation style. Review the writing resources for APA formatting and citation found in Academic Tools. Additional writing resources can be found within the Academic Success Center.

Your submission should:

include a cover sheet/title page;

be double-spaced;

be typed in Times New Roman, 12 -point font;

include correct citations

be written in Standard English with no spelling or punctuation errors; and

include correct references at the bottom of the last page.

If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned without being scored.

Plagiarism

Plagiarism is an act of academic dishonesty. It violates the University Honor Code, and the offense is subject to disciplinary action. You are expected to be the sole author of your work. Use of another person’s work or ideas must be accompanied by specific citations and references. Whether the action is intentional or not, it still constitutes plagiarism.

Search the Walden Library and credible sources for resources explaining the tool or test you selected. What is its purpose, how is it conducted, and what information does it gather?

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Search the Walden Library and credible sources for resources explaining the tool or test you selected. What is its purpose, how is it conducted, and what information does it gather?

 

Nursing Assignment: Assessment Tools and…
nurs 6512 week 2 discussion question part 1
Discussion 1: Assessment Tools and Diagnostic Tests
When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.
In this Discussion, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values.
To prepare:
· Review this week’s Learning Resources, and consider the factors that impact the validity and reliability of various assessment tools and diagnostic tests.
· Select one of the following assessment tools or diagnostic tests to explore for the purposes of this Discussion:
o Mammogram
o Physical tests for sore throat (inspecting the throat, palpating the head and neck lymph nodes, listening to breath sounds)
o Prostate-specific antigen (PSA) test
o Dix-Hallpike test
o Body-mass index (BMI) using waist circumference for adults
· Search the Walden Library and credible sources for resources explaining the tool or test you selected. What is its purpose, how is it conducted, and what information does it gather?
· Examine the literature and resources you located for information about the validity and reliability of the test or tool you selected. What issues with sensitivity, specificity, and predictive values are related to the test or tool?
· Are there any controversies or issues related to any of these tests or tools?
· Consider any ethical dilemmas that could arise by using these tests or tools.
Post 1 page paper APA format a description of how the assessment tool or diagnostic test you selected is used in health care. Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.
Readings
· Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.
o Chapter 2, “Cultural Competency” (pp. 21–29)

This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.
o Chapter 3, “Examination Techniques and Equipment” (pp. 30-49)

This chapter explains the physical examination techniques of inspection, palpation, percussion, and auscultation. This chapter also explores special issues and equipment relevant to the physical exam process.
· Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.
o Chapter 1, “Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis”

This chapter introduces the diagnostic process, which includes performing an analysis of the symptoms and then formulating and testing a hypothesis. The authors discuss how becoming an expert clinician takes time and practice in developing clinical judgment.
· Sullivan , D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A. Davis.
o Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–36)
o Appendices A–E (pp. 225–236)
· Laine, C. (2012). High-value testing begins with a few simple questions. Annals of Internal Medicine,156(2), 162–163.

Retrieved from the Walden Library databases.

This article supplies a list of questions physicians should ask themselves before ordering tests. The authors provide general guidelines for maximizing the value received from testing.
· Qaseem, A., Alguire, P., Dallas, P., Feinberg, L. E., Fitzgerald, F. T., Horwitch, C., & … Weinberger, S. (2012). Appropriate use of screening and diagnostic tests to foster high-value, cost-conscious care.Annals of Internal Medicine, 156(2), 147–150.

Retrieved from the Walden Library databases.

This article highlights the increasing cost of health care and stresses the need for high-value and cost-conscious testing. The authors provide a list of 37 situations in which more testing provides no benefit or may be harmful.
· Shaw, S. J., Huebner, C., Armin, J., Orzech, K., & Vivian, J. (2009). The role of culture in health literacy and chronic disease screening and management. Journal of Immigrant & Minority Health, 11(6), 460–467.

Retrieved from the Walden Library databases.

This article examines cultural influences on health literacy, cancer screening, and chronic disease outcomes. The authors postulate that cultural beliefs about health and illness affect a patient’s ability to comprehend and follow a health care provider’s instructions.
· Wians, F. H. (2009). Clinical laboratory tests: Which, why, and what do the results mean? LabMedicine, 40, 105–113.

Retrieved from http://labmed.ascpjournals.org/content/40/2/105.full

This article analyzes the laboratory testing cycle and its impact on diagnostic decision making. This article also examines important diagnostic performance characteristics of laboratory tests, methods of calculating performance, and tools used to assess the diagnostic accuracy of a laboratory test.
Optional Resources
· LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). DeGowin’s diagnostic examination (9th ed.). New York, NY: McGraw- Hill Medical.
o Chapter 3, “The Physical Screening Examination”
o Chapter 17, “Principles of Diagnostic Testing”
o Chapter 18, “Common Laboratory Tests”