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Essay Instructions: Scenario
Mr. Jack Little is a 59-year-old panel beater with a past medical history of smoking two packs of cigarettes per day for approximately 40 years (80 pack years), chronic bronchitis and cor pulmonale.
Jack was on holidays with his wife in the high, mountainous area when became extremely short of breath. His wife took him to the Emergency Department (ED). On
presentation to the ED, Jack was agitated and dyspnoeic at rest and had a Glasgow Coma Scale (GCS) of 15. His physical examination revealed the presence of loud wheeze in the mid-lung fields, a temperature of 38.5 ? C, SpO2 88% on room air and a respiratory rate of 28 breaths/min. Jack?s lips were bluish color, and he complained of new-onset ankle swelling. During the past three days, Jack has had a productive
cough and was expectorating thick, tenacious, green sputum in the morning on waking up. Dr Santorini ordered a preliminary blood test, chest X-ray and ECG that revealed:
? Blood test - moderate elevation of total white blood cell count (13.0 x 109 /L)
? Chest X-ray ? hyperinflation with flattened diaphragm, increased anteroposterior diameter, no infiltrates or effusions
? ECG ? normal
Based on the preliminary test results Dr Santorini suspects an infective exacerbation of Jack?s chronic bronchitis. Jack was admitted to the medical ward in the Blue Mountains Medical Centre and prescribed pharmacological therapy consisting of intravenous amoxycillin with clavulanic acid, inhaled salmeterol and inhaled ipratropium. Furthermore, Dr Santorini orders two additional tests, arterial blood gas analyses and
spirometry. Arterial blood gas analyses revealed pH of 7.32, PaCO2 of 56 and PaO2 of 62. Spirometry results showed decreased tidal volume and decreased forced expiratory volume in 1 second (FEV1).
Assessment Outline: Case study presentation
? ONLY COMPLETE THE BODY OF WORK NO INTRO OR CONCLUSION REQUIRED.
? The body of work needs to be divided into three (3) main parts:
a) Patients with chronic obstructive pulmonary disease (COPD) present with a number of characteristic signs and symptoms. In relation to the case study, identify the signs and symptoms and link them to the pathophysiological changes underpinning the potential disease process supported by preliminary diagnoses and test results.
b) Discuss the rationale for the additional tests (Arterial blood gas analysis and Spirometry) that have been ordered. Analyse and describe the findings of the additional tests in relation to your patient.
c) Discuss the rationale for medications that have been prescribed to Mr. Little. Describe their mechanism of action, adverse effect profile and outline any potential for drug-drug and/or patient-drug interaction.

Essay Instructions: Directions

Answer the following questions in short essay paragraph format, Each answered questions must have a cited source. A Separate page must list all the references and sources that was presented in each respond.

Questions:
1.Active acquired immunity can be achieved through the use of childhood immunizations. many parents voice concerns regarding the safety of vaccinations. what is your opinion on the current use of vaccinations? how would you educate parents regarding the safety and effectiveness of vaccinations? defend your answers with evidence based research.

2.Share a case study of an electrolyte imbalance from the literature. summarize the case study in 1-2 paragraphs. then discuss the clinical manifestations of the imbalance, the pathophysiology behind the imbalance, normal cell membrane transport of the electrolyte(s), and any alterations in cell membrane transport caused by the imbalance. How was the electrolyte imbalance resolved? analyzed the case study to determine any areas in which patient or staff education may have helped to prevent the electrolyte imbalance.

3.A widespread belief is that caffeine has a diuretics effect when consumed and will induce dehydration if used by athletes or those who perform strenuous exercise. discuss the pathophysiology behind this belief. share your thoughts on whether you agree or disagree that caffeine can induce dehydration. support your answer with evidence based literature.

4. Compare and contrast the pathophysiology between chronic obstructive pulmonary disease (COPD) and Pneumococcal Pneumonia. include any types of cellular injury or cellular adaptation that may occur. evaluate if an inflammatory response is present and discuss the impact of that response. In the case of COPD, discuss the type of patient education you would implement to help with the patient's understanding of the disease and to improve compliance with a treatment plan.

5.Find an evidence based journal on cystic fibrosis and summarize the article in 2 paragraphs. address why you choose the article and how you might use the findings in your current or future practice settings.

6.Atherosclerosis is a common disorder of the arteries. A modifiable risk factor for the development of atherosclerosis is hypertension. discuss the pathophysiology of both disorders and the mechanisms by which hypertension contributes to atherosclerosis. discuss the current medications used to treat both disorder and the pharmacologic actions the medications have in altering the pathophysiology. How can you see this information in your current or future practice settings.

7.Share a case from the literature in which alternative therapies were used to facilitate the management of acute or chronic cardiovascular conditions.

8.Find an article on an inflammatory condition of the lower genitourinary tract. summarize the article in 1-2 paragraphs. discuss the pathophysiology of the condition, the pharmacologic agent(s) used to treat the condition, and how the agent(S) alter the pathophysiology. discuss the role of the nurse educator related to patient education of the reported condition and treatment.

9.Infertility is considered a disease process of the reproductive tract. find an article on an alteration of the genital tract that can lead to infertility. summarize the article in 2-3 paragraphs. discuss any potential treatments. what is the potential psychosocial impact for the patient with the condition?

10. Parkinson's disease is a progressive neurodegenerative disorder. the current treatment options for the disorder have focused on symptom control. Research is now focusing on developing ways to modify the disease progression and possibly provide a cure. investigate the current research on Parkinson disease treatment, including stem- cell research and the use of fetal tissue implants. share thoughts on the evolving therapies. what are the current controversies?

11.Share a case study from the literature on an endocrine disorder. discuss the pathophysiology of the disorder, including the effects on the endocrine feedback, and the role of the hypothalamic pituitary axis. Identify the pharmacologic agent(s) used to treat the disorder and how the pharmacologic agent(s) alters the pathophysiology

12. Human chorionic gonadotropin (HCG) is currently being used as an aid to weight loss in conjunction with an extremely restricted caloric intake of 500 calories per day. many people are buying the HCG through the internet with no medical surveillance. research the HCG diet and share thoughts on the efficacy, safety, and validity of the diet. what strategies would you use to educate patients on the diet?

Essay Instructions: We will pay $160.00 for this order!!

This is a final research paper for a masters degree course in public health- Evaluating Program Outcomes and Impacts that presents a plan for a program and program impact evaluation.
This paper should 1-identify and describe a- smoking cessation intervention program b- provide a logic model with a well developed outcome line c- propose and defend measures for the key outcomes d- propose an impact design to assess program effects on those outcomes with attention to the rationale for selecting that particular design and e- describe how that design would be implemented within the practical constraints associated with the program.
Tha program evaluation to be used is a comparison evaluation with an equivalent control group ( random control trial).

The paper should include the following outline:

I- Program description ( a-setting: Costa Rica universal health system,program done in a group of primary care clinics, goverment funded b- service: smoking cessation program for 12 weeks c- target population: adult population of geographic area assigned to those specific clinics d- intended outcomes: smoking cessation at 6 months and 1 year after program e- logic model : comparison with equivalent group or random control trial , comparison group will be adult smokers patients of other group of clinics where program intervention is not in place)

II- Evaluation plan
a- outcomes to be assessed ( smoking cessation at 6 months and one year post program vrs control group, less acute myocardial infarctions, less prevalence of chronic obstructive pulmonary disease at 5 yrs post intervention)
b- measures- indicators for each outcome ( not just a list, the benefits of each measurement done has to be explained)
c- Impact design
d-Procedures for implementing design and collecting data ( which patients get randomly assigned , how you do this)
e-strengths, limitations and vulnerabilities of design ( the goal is to critique the intervention program plan and evaluation; strengths, limitations and vulnerabilities, what problems could potentially arise)

The paper has to be 10 pages long with at least 6 refernces. I will email the site and password to access the references. Thank you.

The sources for this paper are at the following website:

https://secure.filesanywhere.com/index.html

username: institute
password: participant

The primary readings for section I Identifying, Conceptualizing , Measuring...., section II A Randomized Field Experiments and Section III Design Sensitivity and Effect size are the most important.

Essay Instructions: Please read the below requirements before you begin writing the personal statement about pathology:

There are some basic questions that you need to address in your personal statement. These are usually divided into three paragraphs that address: 1) what got you interested in the field that you have chosen; 2) what are you looking for in a residency program; and 3) what are your expected goals in the field you have chosen. You are always free to add other commentary that is relevant to the above topics. But, make sure you discuss these 3 topics in your essay.

Please include my background information in the statement:
My CV
From 2009 I started working at Howard University Hospital cancer center as a research Assistant . During my research
I had a chance to go to pathology department to collect the specimen regarding my research and had a chance to Observe in pathology and work with attending and resident . Had a chance to see surgical pathology how the lab works,gross the specimen ,histology and amazed by correlating histology to medicine, molecular testing has great impact on diagnosis and treatment of the patient.

Graduate Education:
Bachelor of Medicine & Surgery (M.B.B.S)
MEDICAL SCHOOL: Sindh Medical College, University of Karachi, Pakistan, 1995-2000.

CERTIFICATION:
ECFMG certificate, 03/2006

CLINICAL EXPERIENCE:
Internal Medicine, Jinnah Postgraduate Medical Centre at Karachi Pakistan. 2001
Nephrology: Dealt with acute renal failure, glomerulonephropathies, chronic renal failure, renal replacement therapies (hemodialysis, peritoneal dialysis), fluid and electrolyte disorders.
Chest Medicine: Worked with chronic obstructive pulmonary diseases, pleural effusion, pneumonia, lung abscess.

Obstetrics and Gynecology, Jinnah Postgraduate Medical Centre at Karachi Pakistan. 2001
Resposibilities included routine post partum deliveries, couplet care (mothers and babies), high-risk post partum C-sections, diabetes, pregnancy induced hypertension, pyelonephritis, post partum hemorrhage, and teenage pregnancies. Other areas of skills include transitional and newborn nursery and stabilized pre-term labor.

Skills and Strengths:  
Works well under emergency conditions
Strong attention to detail and standards of practice
Highly motivated team player .
Proficient with computer literate such as Microsoft Word , Microsoft Excel ,Power point and Internet.
Experience in a variety of medications and injections
Worked with a variety of hospital teams, in both large and small hospital settings
Well rounded background in many patient care environments and cultures
Very dependable with strong managerial, communications, and people skills
Experienced in adult, adolescent, pediatric and infant health
Proficient in English, Urdu, and Punjabi.



Publication:
Hassan Ashktorab; Roshila Mohammed ; Edward L. Lee; Hassan Brim, 2010 , Colorectal Cancer in Young African Americans, Could race be a risk factor? A 30 Year Experience In An Inner City Teaching Hospital,AACR,101st Meeting # 2714

Experience:

Research Assistant, Howard University Hospital, District of Columbia, 07/2009 - Present
Collecting data about survival rate of colorectal cancer in inflammatory bowel disease patients. Monitor study progress such as patient recruitment and protocol compliance. Also contributed and develop several PowerPoint presentations for continuing education. Assist with other projects and duties as assigned.

Andrology Lab Technician, Shady Grove Fertility, Rockville, Maryland, 04/2005 ??" Present
Interaction with patients, physicians, and other healthcare personnel. The work involves performing semen analyses, sperm washing for intrauterine inseminations and sperm cryopreservation. Also gained experience auditing and maintaining sperm tanks, liquid nitrogen storage system and laboratory equipment. Practiced laboratory quality control/quality assurance, recordkeeping, data entry and inventory maintenance. Gained exposure into In Vitro Fertilization Therapies by witnessing egg retrievals, fertilizations and embryo transfers. Witnessed embryo cell biopsy and subsequent chromosomal analysis of the cell.

Extern, Veterans Affairs Medical Center, District Of Columbia, 06/2007-10/2007
Responsibilities include extensive and comprehensive evaluation of new patients; evaluate treatment of existing patients and adjust medication accordingly. Treat substance abuse patients, substance related psychiatric problem as well as patients with underlying psychiatric problems. Attend service-wide didactic programs and help in diagnostic assessment. Also, attend and observe group therapies on weekly basis. Educate patients on several health issues.
Consult inpatients in substance abuse problems and substance related psychiatric problems

Observer, Physician Associates of Germantown, Maryland, 06/2007 - 07/2007
Observed physician-evaluating patients in an outpatient clinic. Gained exposure to patient assessment used by physician to diagnose various disease such as diabetes, hypertension, hypercholesterolemia, heart disease, infections and several others.

Volunteer, Georgetown University Pediatrics, Washington, D.C., 06/2006 ??" 12/2006
Visited and counseled patients and families. Provided comfort and support to patients and families during treatment. Escorted patients to their assigned rooms. Supervised and monitored patients. Assisted admitting staff with reception. Worked together with hospital staff to plan out patient's weekly activities.

Observership, Shady Grove Fertility Center, Rockville, Maryland, 08/2006 ??" 09/2006
Spent 80 hours observing patient consultations and procedures with founding physician. Consultations involved new as well as follow-up patients with topics including InVitro Fertilization and preimplantation genetics. Observed IVF and Intrauterine insemination, embryo transfers, sonograms, fluid contrast sonograms, hysteroscopies , D&C’s and hysterosalpingographies.

Physician, Zainab Panjwany Medical Center, Pakistan, 12/2001 - 04/2003 
Worked in outpatient clinics and cared for patients in the ward. Carried out emergency duties and gained exposure to various medical emergencies.  Also, performed diagnostic procedures such as pleural fluid aspiration, ascitic tap and lumbar puncture independently. Responsibilities included taking patient histories, physical examination and follow up visits. Prepared and gave presentations on various medical cases.