Noninvasive First Trimester Screening for Trisomy 21

Trimester Screening
RUNNING HEAD: Noninvasive First Trimester Screening for Trisomy 21
Noninvasive First Trimester Screening for Trisomy 21 2
Evidence Based Practice
Noninvasive First Trimester Screening for Trisomy 21
University of Mary Courtney Goodnough, RN, BSN April 21, 2017
Introduction
There are many different options for pregnant women regarding screening for trisomy 21. There are
two more common types of tests available, nuchal translucency ultrasound with biochemistry testing
in the first trimester, and cell–free DNA testing starting at 10 weeks until delivery. With these
options come many questions about which one is more accurate in ... Show more content on
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The information found is supported by evidence and is the same we use in our practice. The
problem is that insurance companies will pay for standard screening with Nuchal Translucency, but
they will not pay for cell–free DNA testing unless the standard screening comes back high risk, the
patient is advanced maternal age, or has a history of a previous birth affected by aneuploidy. Cell–
free DNA testing includes X Y analysis, so the patient is able to find out the sex of the baby around
10 weeks. This is becoming a popular request just to find out the gender. Insurance companies have
now caught on to this trend, and are refusing to pay for the X Y analysis of the cell–free DNA test,
which does include specific abnormalities associated with X Y abnormalities. Medicaid will cover
the standard screening, but will not pay for cell free DNA testing. We have 3 patients at high risk
and have done prior authorizations through Medicaid, they still refuse to cover. One being a patient
who tested high risk for trisomy 21 on her standard screening, one who is advanced maternal age,
and one who had a previous pregnancy with a child with Down
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Symptom Management Theory ( Smt ) Of The University Of...
Symptom Management Theory The symptom management theory (SMT) of the University of
California, San Francisco (UCSF), was revised by its faculty and students in 2001 (Smith & Liehr,
2014). According to Dodd et al. (2001), the subjective experience that suggests alterations in an
individual's functioning, sensation, and cognition is called a symptom. Dodd et al. state that their
theory provides a nonspecific symptom management model to guide nursing practice and research.
The SMT has three overlapping circles which contain the three domains of nursing science, also
known as concepts of metaparadigm of nursing. The three nursing science domains are the person,
the environment, and health & illness. In the theory's model, the dimensions are affected by the
three nursing science domains (Dodd et al., 2001).
According to Dodd et al. (2001), there are three dimensions included in the SMT. First is symptom
experience, which includes the person's viewpoint, evaluation, and reaction to the symptom. The
second dimension is symptom management strategies, which are interventions that are intended to
postpone and reduce, if not able to totally prevent, a negative outcome from symptom experience.
The interventions that are done may be focused on resolving one or multiple components of the
person's symptoms to attain the planned outcomes. The last dimension is the symptom status
outcome, which is a result of interventions done during symptom management strategies. Multiple
aspects are

Promoting Positive Health Behaviors: Prevention Programs...
With an increase in the number of annual deaths caused by cancer in the US population, there have
been many efforts by numerous private and public entities to create programs aimed at prevention of
certain types of cancer. Due to ineffective intervention strategies many programs struggle to produce
positive outcomes. The purpose of this paper is to summarize the Every Woman Matters Program
(EWM), its' ineffectiveness and the reasons as to why the program was unsuccessful. I will
summarize and analyze two other prevention programs that succeeded at the goal of advocating and
promoting health and prevention. Also, I will describe two strategies for creating a more effective
prevention program.
The Every Woman Matters Program The ... Show more content on Helpwriting.net ...
To carry out the study seven primary care practices were chosen to participate over a total period of
a year. At each site the research nurse collected qualitative data pertaining to the process of pap and
mammogram service delivery from field notes, interviews with patients and physicians. This data
was then used to identify the barriers and areas that needed improvement in the facilitation of these
preventive services. "Despite the use of the GAPS model and a financial incentive to obtain "buy in"
from providers and staff, change was difficult for all but 2 of the practices" (Backer et al., 2005).
Due to poor leadership and willingness to change, the other five practices had poor outcomes.
Backer et al. (2005) stated that "Changing practice behavior entails teamwork among clinicians and
staff, requires flexibility and willingness to change, and should be based on individualized
interventions based on each system's unique and dynamic pattern" (p. 402).
Effective Prevention Programs that Advocate for Early Screening According to the World Health
Organization (2014), there are two major components of early detection of cancer: education to
promote early diagnosis and screening. In this section I will summarize the characteristics of two
prevention programs that advocate for early screening, describing what made them successful.
Community–Based Free Prostate Cancer Screening

The Economics of Prostate Cancer Screening Essay example
Introduction This paper will focus on the economics of prostate cancer screening. The American
Cancer Society states that cancer is a group of diseases characterized by uncontrolled growth and
spread of abnormal cells. If the spread is not controlled, it can result in death (10). According to the
Centers for Disease Control and Prevention, cancer is the second leading cause of death. In 2002
alone, half a million Americans will die of this disease. Of this numerical figure, it is estimated that
perhaps more than 1,500 individuals a day will die. In addition, one of every four deaths in America
is from cancer (9). Among Medicare–age men, prostate cancer is a common and serious malignancy.
The American Cancer Society (ACS) indicates ... Show more content on Helpwriting.net ...
An indicator of the future course of prostate cancer is predicted by tumor grade and stage. The age
of the patient does not seem to play a role in the rate at which tumors spread and become life
threatening. At the present moment, determining the stage of prostate cancer without surgery is
unreliable. As soon as the cancer spreads to bones or other organs, hormonal treatments can only
achieve temporary remissions often measured in months. African–American men and men with a
family history of prostate cancer are at most risk. Statistical date presented by Philip W. Kantoff,
MD, Associate Professor of Medicine, Harvard Medical School and Director points out that among
African–Americans, in the world, this population comprises 224 cases per 100,000. In comparison
to other populations, the incidence of prostate cancer in African–Americans stands in stark contrast
to the incidence in white Americans with 150 cases per 100,000 and among men in Western Europe,
39.6 cases per 100,000, Japan, 8.5 cases per 100,000, and China, 1.1 cases per 100,000 (2). In
addition to being an African–American male or a male with a family history of prostate cancer,
recently, prior vasectomy and a high fat diet has been proposed as possible additional risk factors.
Along with these factors, the probability of harboring asymptomatic prostate cancer increases as
men age: approximately 22 percent of men in their 60s and 39 percent in their 70s (2).
Cost of Prostate

Hearing Screenings
Without hearing screenings average diagnosis of permanent hearing loss is greater than 2 years old.
Late diagnosis of hearing loss has been one of the contributing factors of reduced language skills in
children (Durieux–Smith, Fitzpatrick, & Whittingham, 2008). Since the early 1980s, the Joint
Committee on Infant Hearing has published recommendations and multiple position statements
which support the use of newborn hearing screenings, to decrease the age of diagnosis of children
with permanent hearing loss. By 2000, there was a federal law to support universal newborn hearing
screenings (UNHS). The law also promoted early intervention for children with hearing loss, in
hopes to improve speech/language abilities for children with hearing loss ... Show more content on
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The study included children who received a diagnosis of a congenital or early–onset (before 6
months) permanent hearing loss that was not medically treatable (Durieux–Smith et al., 2008). Data
was collected from the groups of children who were identified with permanent hearing loss through
a targeted high–risk screening program, a universal newborn hearing–screening program, or through
a medical referral either with risk factors or without factors. Data on the onset of permanent hearing
loss, route to referral, etiology, age at diagnosis, and amplification fitting were all obtained from
their medical charts to determine the primary outcomes of language abilities with early
identification. Results from the study showed children screened at infancy were diagnosed earlier
than those referred with risk factors (Durieux–Smith et al., 2008). Children with risk factors, in turn,
were diagnosed earlier than referred without risk factors. Although, the age of diagnosis of referred
children was seen to improve over time, it remained significantly higher than children receiving
screenings. However, this trend of earlier diagnosis may reflect greater awareness of hearing loss.
Results from this study indicate UNHS leads therefore earlier diagnosis and to earlier amplification,
which then leads to earlier auditory stimulation (Durieux–Smith et al.,

LDCT Screening
According to recent studies at Indiana Universty School of Medicine, alternative methods for
detecting non–small cell lung cancer are emerging. The current methods of detecting NSCLC may
be effective, but they are also very expensive. One method called a low–dose computed tomography
(LDCT) has been successful in identifying malignant tumors. However, routine LDCT screenings
would result in 1.3 to 2 billion dollars nationally in health care costs annually. Deig, Mendonca, and
Lautenschlaeger suggest that pursuing other methods of screening for NSCLC would significantly
decrease this cost. If screenings could be conducted in a cost efficient and effective manner, then the
expensive LDCT procedure would only have to be conducted for patients who ... Show more
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Biomarkers are natural indicators in the body that respond noticeably to the presence of disease. By
measuring the responses of biomarkers, oncologists detect the cancerous cells before recommending
expensive procedures, rather than immediately resorting to these procedures. One of these
biomarkers that responds to the presence of cancerous cells is microRNA. MicroRNAs are
molecules that are involved in the cell life cycle and therefore the progression of cancerous cells. A
study in cancer patients was conducted to compare the accuracy of screening with microRNAs to
screening with LDCT. Observing microRNAs did not prove to be as accurate at identifying cancer
as LDCT, but since using microRNAs is a less expensive process, it can identify patients that should
undergo LCDT testing. Screening with microRNA testing initially would decrease the number of
patients paying for LCDT testing. Another biomarker that can be observed in response to cancer is
ct–DNA. Ct–DNA refers to fragments of DNA from tumors found circulating in the blood stream. A
recent study indicated that observing ct–DNA could have multiple useful applications for
oncologists. Ct–DNA analysis during treatment could serve as an indication of how tumors react to
treatment methods and whether recurrence is likely. Detecting ct–DNA in the bloodstream could
even serve as an early sign of cancer, observable before imaging tests even show tumors. However,
ct–DNA analysis has not yet proved to be a replacement for LDCT

Prostate Cancer Essay
Area of Interest Prostate cancer being a huge cause of mortality and medical expense in men age
forty and above has only recently become a topic of general conversation to men in America
(Plowden, 2009). African–American men are affected by prostate cancer at a disproportional level
than all other men. They are diagnosed up to 65% more frequently and the mortality rate is twice
that of Caucasian counterparts (Emerson, 2009). The African–American male is also less likely to
take advantage of free prostate cancer screening (Oliver, 2007).
Current state of the science Today, prostate cancer is usually detected through screening, and there
are two methods for early detection. The prostate–specific antigen test (PSA) is used, but there are
... Show more content on Helpwriting.net ...
Early intervention is the key to a 5 year survival rate. Prognosis of prostate cancer diagnosed at an
early stage is noted as being optimistic. Despite these credible statistics, free prostate cancer
screening and early detection remains a problem area for many health care practitioners when it
comes to the African American population (Plowden, 2009).
Leininger's Sunrise Model Madeline Leininger's Sunrise Model has been used in many studies over
the past twenty years. Between 1999 and 2008, over 200 citations of articles were noted using
Leininger Theory (McEwen, 2011). She postulated that nurses should attempt to increase knowledge
related to the care of people who value their cultural heritage and way of life (McEwen, 2011). The
Leininger Sunrise Model of cultural diversity is used to obtain compliance with prostate cancer
screening among African–American men; the goal has been to build a relationship of cooperation
between clients and health care workers. Educating the men as well as examining their fears and
anxieties is useful in removing barriers of resistance and gaining trust, thus empowering the client
(McEwen, 2011).
Theory, model, concepts, propositions, strengths and limitations The Health Belief Model (HBM)
"postulates a person's perception of disease threat and benefits of taking action will predetermine
taking action" (Rivers, 2009). The HBM is used to determine the African American male
understanding of prostate

Prenatal Screening
According to https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072602/ antenatal screening are
done on 'people who do not feel ill' and so suggest that screening can very useful for midwives in
helping them detect disorders before any outward signs or symptoms are shown and allows
midwives to identify babies that are at a high risk of a disorder and so prenatal diagnosis establishes
whether or not the disorder is definitely present which can then lead to the disease being treated at
an earlier stage. Screening does not replace diagnosis; it aims to provide midwives and mothers with
information which can help them with further decision making.
CHORIONIC VILLUS SAMPLING AND AMINOCENTESIS
According to https://en.wikipedia.org/wiki/Amniocentesis amniocentesis is a medical procedure
which is used in prenatal diagnosis of chromosomal abnormalities and fetal infections as described
below. Amniocentesis carries a small risk for both mother and child and so the test may be offered to
mothers who have a significant risk for genetic diseases. However, according to
https://www.google.co.uk/#safe=strict&q=chorionic+villus+sampling&*&spf=115 Chorionic Villus
Sampling (CVS) is a test done during the early stages of pregnancy to detect congenital
abnormalities in the fetus. It allows the mother to be checked for any signs of Down's syndrome,
Edwards' ... Show more content on Helpwriting.net ...
Boys are usually affected more severely than girls. Most babies with this disorder are born to
couples who don't have a family history of the disorder so screening is needed to determine the
couple's carrier status. Both parents provide blood samples and the women's sample is tested to see
whether she is a carrier. Amniocentesis and chorionic villus sampling can both be used to screen for
fragile X and

Essay On Prostate Cancer
One of the most common cancers to be diagnosed in men, prostate cancer has a good prognosis
when diagnosed early. Approximately 2.8 million men in the United States have prostate cancer.
Raising awareness for this type of cancer is key in being able to detect this cancer early and saving
more lives.
Definition
Prostate cancer begins in the prostate, which is a walnut–shaped gland that is responsible for
producing seminal fluid. Some types of prostate cancer grow slowly and may need very little
treatment, while other types grow quickly and aggressively.
Symptoms
Unfortunately, in its very early stages prostate cancer has few symptoms. As the tumor grows it
begins to affect the body. These signs include:
trouble urinating blood in the semen ... Show more content on Helpwriting.net ...
Most recommend screening beginning at the age of 50, with screening starting sooner for those who
have a history of prostate symptoms.
Diagnosis
A digital rectal exam (DRE) can be a useful tool in screening for prostate cancer. A doctor will insert
a gloved, lubricated finger into the rectum. The rectum is adjacent to the prostate and abnormalities
in the size, shape or texture can indicate the need for further testing.
A blood test that tests for prostate–specific antigen (PSA) may also be done. Normally a small
amount of PSA is in the blood for healthy men; a higher amount can indicate abnormalities with the
prostate. The PSA combined with the DRE test has the highest rate of discovering prostate cancer in
its early stages.
If abnormalities are found during screening, an ultrasound and a prostate tissue biopsy will be done
to determine if the patient has prostate cancer.
Treatment

If the cancer is slow–growing, no treatment may be necessary. Doctors will monitor the tumor to
determine if it's growing and if further action needs to be taken.
In cancers that are more aggressive, radiation to kill the cancer cells, hormone therapy to slow the
production of testosterone or surgery to remove the prostate may be

Hypothetical Screening
Think of hypothetical screening programs for diseases of interest to you; find one example of a
disease where high sensitivity would be more important, and one example where high specificity
would be more important. Screening programs utilize diagnostic tests on individuals who are
asymptomatic of certain diseases and the intent of diagnostic tests are used to establish the
probability of having a certain disease (New York State, Department of Health (n.d.). As a provider,
the fundamental intention of screenings is to reduce morbidity and mortality; however, providers
must also understand the potential affect on individuals if results reveal false–positives and false–
negatives (Gates, 2001). Therefore, diagnostic accuracy is critical and making sure quality of
screenings is important in that the tests are sensitive enough to detect disease during the period in
individual who do not have symptoms of a particular disease and specific enough to lessen the
incidence of false positives (Gates, 2014). Screening the female population with Pap (Papanicolaou)
smears for cervical cancer is considered a sensitive test (Lalkhen & McCluskey, 2008). ... Show
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Therefore, it is the period of time between early diagnosis with screening and the time in which
diagnosis would have been made without screening (Gates, 2001). Thus, lead time is an important
factor when evaluating the effectiveness of screening programs. According to Gates (2001),
advancing the time of diagnosis solely does not validate screenings because those diagnosed early
are not living longer per se compared to those individuals that are not screened. Therefore, the best
way to avoid lead–time bias is to compare actual mortality rates in the screened and unscreened
populations through randomized trials (Gates, 2001; Gordis,

J Adams's Theory Of Prostate Cancer
In 1853, J. Adams, a surgeon at The London Hospital, documented the first case of prostate cancer.
This was discovered by a histological examination. He documented in his report that this condition
was "a very rare disease." (Adams, 1853) At that time it was not clear to track the trend of prostate
cancer as it now poses as a significant health problem. "In the United States, it is the most
commonly diagnosed cancer in men, with 180,000 new cases and about 31,000 deaths occurring
annually." (Greenlee, Hill–Harmon, Murray, T. & Thun, M, 2001) This number has been an increase
due to three different causes. The first is that prostate cancer did not become differentiated from
other types of urinary obstruction until the early 1900s. The next cause ... Show more content on
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In 2015, approximately 220,800 men will be diagnosed with prostate cancer, and more than 27,540
men will die from the disease. One new case occurs every 2.4 minutes and a man dies from prostate
cancer every 19.1 minutes. It is estimated that there are nearly 3 million American men currently
living with prostate cancer. A non–smoking man is more likely to develop prostate cancer than he is
to develop colon, bladder, melanoma, lymphoma and kidney cancers combined. (PCF, 2015)
Studies have also shown that men are 35% more likely to be diagnosed with prostate cancer than
women are to be diagnosed with breast cancer. (PCF, 2015) With respects to our central focused
(target group): men over 65; the African American race, and individuals with a family history of the
disease are subject to increase the likelihood of being diagnosed with the disease. The Prostate
Cancer Foundation also found the

Hearing Screening
Prior research has indicated that screening children for hearing loss as young as possible is
imperative, so that children with a hearing loss can receive treatment or an amplification device.
Failure to identify and manage hearing loss in adolescents can lead to impaired speech and language
development, poor social skills, and educational delays. Children in developing countries typically
do not receive newborn hearing screenings and they may not receive hearing screenings in school.
Cost, accuracy, accessibility, and trained personal are four of the major issues concerning the
absence of hearing screenings in developing countries. It was postulated that computer–based
audiometer software was a low–cost, accessible option for developing countries that could be easily
operated by less formally trained individuals.

Mammogram Screening
Medical screening and testing continues to grow and advance every day. These various advances
allow us to detect harmful effects on the body such as cancer, much sooner because it allows us to
regularly check patients as a precaution. Some screenings are not mandatory; however, having the
screening done is very beneficial in detecting early stages of cancer. One of the most common
screening among women is mammograms. Breast cancer is the second leading cause of cancer
deaths in U.S. women. Early detection is associated with increased survival and annual routine
mammogram screening has until recently been recommended to all women aged 40–74 years of age
in the United States.1 Overall effectiveness of a mammogram does not only include the ... Show
Recently the age at which women should start getting mammograms has increased having a
negative effect. Research shows that approximately 17% of breast cancer deaths could have been
prevented if women aged 39–49 years of age had regular mammography screenings.6 The absolute
number of breast cancer deaths in U.S. women aged 40–49 was 4,327 in 2005. A 17% reduction
therefore translates to approximately 735 fewer deaths if all women in this age group had undergone
regular mammography screenings. Currently, the use of mammography screening in the United
States is 22% among women <40 years and 36% among women aged 40–47.1 Although
mammograms are not one of the easiest or pleasant screenings to have done, it is very beneficial to
women in order to catch the early stages of breast cancer and act quickly to prevent the

Prostate-Specific Antigen (PSA) Analysis
Response # 2
Hello Marvis Bellagwa,
I enjoyed reading your great post. The prostate–specific antigen (PSA) analysis is indeed the utmost
essential test in men's health utilized to screen substantial populaces for prostate cancer, which have
shown to decrease the number of men with advanced prostate cancer. According to Moyer (2012),
the U.S Preventive Service Task Force {USPSTF} indicated there is greatest controversial related to
the efficacy or actual believability in the discovery and following patient survival, henceforth, the
propose is a PSA contradiction screening amidst men aged 75 years or older. Furthermore, it
indicated currently the equilibrium amid the benefits and disadvantages of prostate cancer screening
amongst men below age 75 years indeed cannot actually be measured related to inadequate evidence
(Moyer, 2012). In–spite of the recommendation of the USPSTF, arrays of urologist attest to the
advantages of PSA test. According to American Cancer Society {ACS}, 2010 guideline related to
early discovery of prostate cancer emphasized the significance of incorporating the men in the
decision of either to test for prostate cancer or not; even though ACS acknowledged the advantages
of PSA in lessening the probability of dying from prostate cancer (Wolf, Wender, Etzioni ,
Thompson, D'Amico, Volk, et al., 2010). The ACS guideline also noted that the risk involved is
enormous especially with actual treatment ... Show more content on Helpwriting.net ...
A. (2012). On behalf of the U.S. Preventive Services Task Force. Screening for Prostate Cancer:
U.S. Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine,
157(2), 120–134. doi: 10.7326/0003–4819–157–2–201207170–00459
Wolf, A. M. D., Wender, R. C., Etzioni, R. B., Thompson, I. M., D'Amico, A. V., Volk, R. J., ... &
Smith, R. A. (2010), American Cancer Society Guideline for the Early Detection of Prostate Cancer:
Update 2010. CA: A Cancer Journal for Clinicians, 60(2), 70–98.

Denver Developmental Screening Test Analysis
The Denver Developmental Screening Test, is a screening tool developed to identify young children
0–6 years of age at risk for developmental delay and disability. Its format is comparable to the
structure of pediatric growth charts, and is divided into four distinct developmental domains:
personal–social, fine motor–adaptive, language, and gross motor. The test can be administered with
ease, in less than an hour and scoring is based on observation, and parental reporting (Encyclopedia
of Autism Spectrum Disorders). The data is coincided in relation to normative values on a curve
similar to a growth curve putting each child in a percentile rank. The Denver Developmental
Screening Test is not a predictor of later development; it provides an organized ... Show more
enjoyed her experience. Because she knows me personally I found it very easy to talk to her, and
she had no difficulty engaging in conversation with me. S.G. failed two tasks; defining seven words
in the Language category, and balancing on each foot for 4, 5 and 6 seconds. The chronological age
line does not fall through the blue part of the bar for those specific tasks, and therefore it is not
concerning. Although she did not succeed in completing these two tasks, today's Denver
Developmental Screening Test was normal. It was a pleasure performing this test on S.G. and, if
given the chance to reassess her I would perform the exam in a more private setting, away from all
the distractions so that she may be able focus solely on the exam. According to beststart.org's "On
Track Guide" as far as development by age and domain is concerned S.G. accomplishes the skills
listed for children her age

Detecting Prostate Cancer : Cancer And Second Most Common...
Detecting Prostate Cancer
According to Ferrante, Shaw, and Scott (2011), prostate cancer is the most common cancer and
second most common cancer death among men in the United States. Early detection permits
appropriate and timely management, which can allow clinicians to treat the cancer effectively. When
detected at early or regional stage, prostate cancer has a five–year survival rate of about 100%.
Prostate–specific antigen (PSA) is the most widely used tumor marker and was approved by the
FDA in 1994 as an aid in the early detection of prostate cancer (Duffy, 2011). PSA screening helps
detect prostate cancer earlier, at lower clinical stages, and with a lower Gleason score (Cho et al.,
2015).
PSA has become the most important biomarker for detection and follow up of prostate cancer. PSA
levels of greater than 4.0ng/ml have been considered to have predictive value for prostate cancer.
This screening test is well tolerated, quick, cheap, and standardized. Physicians are also familiar
with the test results and can easily translate (Roobol et al., 2011). According to Wachtel, Nelius,
Haynes, Dahlbeck, and de Riese (2013), the United States Preventative Health Task Force recently
recommended PSA screening be abandoned in part by examining the results of two randomized
trials, concluding that the results did not support the notion that the benefit of PSA screening
outweighed the risks and costs even though there has been a steady decline in mortality since the
early 1990s.

Immunohistochemistry
Within a Single Institution
Although there are many methods that help with diagnosing prostate cancer such as biomarkers and
needle core biopsy, it is the practice patterns of different pathologists that in the end determine the
diagnosis. This article explains how and why interobserver variability can affect the ability to
diagnose prostate cancer. Additionally, it determines the outliers for immunohistochemistry work
up. Immunohistochemistry is a method that can help aid the diagnosis of prostate needle core biopsy
specimens. This procedure looks at the small foci of prostatic adenocarcinomas and limits the over
diagnosis of non–neoplastic look–alikes.
This study analyzed immunohistochemistry usage and data as well as practice patterns from many
pathologists at a tertiary care center to identify the outlying practice patterns. Prior ... Show more
The cases were placed into four categories: non–neoplastic, high grade intraepithelial neoplasia,
atypical small acinar proliferation, or adenocarcinoma. The findings showed that there were either
lower rates of non–neoplastic diagnoses with higher rate of high grade intraepithelial neoplasia, or
vice versa. The diagnosis of adenocarcinoma and atypical small acinar proliferation had no
significant variability between pathologists. The study suggests that institutions should analyze
pathologists practice patterns to determine if the pathologist is an outlier with errors in his/her
diagnosis. This would affect clinical management. Along with determining the pathologists'
diagnoses, immunohistochemistry use was also observed. The rate of immunohistochemistry usage
was lower than other tertiary care centers. Also, immunohistochemistry was used greatly to
determine adenocarcinomas. The articles reports "efficient use of IHC's in diagnosing prostate
biopsy specimens could have important cost–saving

Risks of PSA Testing Essay
PSA test results are interpreted as: 0–4 ng/mL is normal. Between 4 to 10 ng/ML is 25% of
developing cancer, and > 10 ng/ml is a > 50% risk of cancer. However, some men with normal PSA
levels still have prostate cancer, while other men with high PSA levels do not. PSA levels increase
with age often due to a higher prevalence of benign prostate hypertrophy (BPH). Therefore, no PSA
cutoff can accurately guarantee that a man does not have prostate cancer. PSA blood levels are used
for several different purposes such as to diagnose prostate cancer, evaluate treatment of prostate
cancer, and to evaluate the severity of benign prostatic hyperplasia (BPH). Currently there is no way
to determine between prostate cancers that is aggressive verse ... Show more content on
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The ACS guidelines also recommend screening men who are at high risk as early as 40 years of age
(black, relative that was diagnosed young, Braca 1 (breast cancer) 1 or Braca 2. However, the
USPSTF advises against PCa screening concluding there is moderate certainty that the benefits of
such screening do not outweigh the harms (Quaseem et al., 2013).
In the case for PSA screening, PCa is the leading internal malignancy in US men and the second
leading cause of cancer death in American men. Early detection of prostate cancers offers the best
chance of cure. The PSA blood test is the best chance of cure. Currently, the PSA blood test is the
best currently available way to detect PCa and it is easy, safe and inexpensive. PSA test results is a
piece of information, it is what doctors do with the information that becomes the issue. However,
the great majority of PSA detected tumors have the histologic characteristics of clinically important
cancers. Also, PSA detection has found tumors early advancing the diagnosis by Seeral years (5–13)
and prostate cancer mortality rates in U.S have decreased by 4% (patho book) since 1992, which is
5 years after initiation of prostate screenings. The dilemma is over treating the clinically
unimportant disease versus under

Cancer Screening
Care Services and Cancer Screenings
There are a wide variety of cancer types. They all have several things in common, however. Each
cancer starts with cells that become abnormal or cancerous. These cells reproduce and form a mass
of cancerous cells. This mass is called a tumor. When the cancerous cells spread, or metastasize,
they can impact other tissues, organs, and systems of the body. A second commonality among
cancers is that when they are detected early, they are easier to treat and the treatments are more
likely to work. In many cases, a cancer that is caught early can be completely destroyed.
The primary way to detect cancer is through cancer screenings. Screening are simply routine checks
that take place prior to body showing signs ... Show more content on Helpwriting.net ...
The benefits far outweigh those risks, but it is still important to be informed. Some of the risks of
cancer screenings include false positive results that lead to great emotional turmoil and/or needless
treatment; false negative results, which give a person undue confidence in their health when they
actually have a serious condition; and actual damage to the body during the test, such a punctured
colon during a colonoscopy.
It is also important to remember that screenings can only detect cancer. They are not a cure, and
even if the cancer is detected, it does not mean that the cancer will always be eradicated. Early
detections does significantly increase the odds of success, however.
Senior care services can help your senior loved one keep up on their annual exams and schedule
screenings as necessary. Further, they are able to provide the transportation to and from
appointments. This is particularly important with screening such as a colonoscopy where anesthesia
is used. Senior care personnel can also be there to provide care for your loved one while they are
recovering from these procedures, as some can be quite

Research Paper On Baldness
Baldness is a common occurrence among men. It is typically regarded as something normal and not
indicative of any kind of health condition, although it may cause psychological distress in the
affected. However, scientists have discovered positive correlations between baldness and several
pathologies. Male–pattern hair loss, as it is formally known in the medical realm, affects at least
50% of men in old age. Its causes are believed to be largely genetic. Recent studies have finally
shed some light on the genetic underpinnings of the condition, revealing several complex
relationships with other diseases and innate traits.
Shortness and baldness
According to scientists at the University of Bonn, Germany, short men are more likely to experience
hair loss prematurely. They studied the genetic material of more than 20,000 men from around the
world. Slightly less than half were bald men. After analyzing the data, the team of scientists led by
geneticists Dr. Stephanie Heilmann–Heimbach and Prof. Markus Nöthen discovered that
prematurely bald men carried 60 genomic alterations. These genetic signatures meant that
prematurely bald males are more likely to undergo puberty earlier, to have small body size, and to
develop several types of cancer (including prostate cancer). Associations between bone density and
light skin color were also found. The study––now published in the ... Show more content on
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The objective of this research effort was to help scientists see how and why hair loss arises from
genetic factors. 287 genetic regions were identified, and, surprisingly, many of them derived from
the X chromosome, which is inherited from the mother. Scientists expressed that one of the long–
term implications of this research is the creation of a genetic tool that helps predict hair loss patterns
in the future. The study was published in the PLOS Genetics

Prostate Cancer Research Paper
Prostate cancer is considered as the most commonly diagnosed cancer in men, in the U. S and most
cases of prostate cancer have a good prognosis. Some of these cases can be aggressive and the
death–rate is assessed to be 2.8%. The Prostate–specific antigen (PSA) test is used for screening for
prostate cancer, to aid early detection and treatment.
Prostate–specific antigen (PSA) test Prostate–specific antigen (PSA) is a protein produced by the
prostate gland, found in the blood. Blood sample is utilized to check PSA levels and Lab results are
reported in nanograms of PSA per milliliter (ng/mL) of blood. 4 ng/mL is considered to be the
normal level of PSA. Levels of PSA in the blood may be elevated in patients who have prostate ...
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Although PSA Screening tests can facilitate to detect prostate cancer in its early stage, there is
controversy and concern about patient being unnecessarily treated and over–diagnosed. The
reliability of prostate specific antigen (PSA) testing is very poor. PSA values could be false positive
caused by conditions such as benign prostatic hyperplasia, ejaculation, perineal trauma and PSA
value cannot be used to rule out prostate cancer. PSA–screening misses a considerable number of
patients with PCa (false–negatives) and wrongly suspects or false–positives (Hayat, Nordin and
Berglund, 2013). Sensitivity of the test is determined with the percentage of people tested with the
disease that had positive results equals the number of patients that were true positive. The cut–off
range for an abnormal PSA screening is 4.0 ng/mL. The American Cancer Society estimated that,
the sensitivity of a PSA levels cutoff of 4.0 ng/mL, was twenty one percent for detecting any
prostate cancer and fifty one percent for detecting high–grade cancers (Gleason ≥8). Validity of the
test can be determined by the ability of its screening to accurately identify, if the patient has the
disease or not. With PSA screening alone, one cannot validate if the patient has prostate cancer and
other diagnostic tests such as digital rectal exam

Congenital Disorders With Intellectual Disability
Chapter Five
5. Discussion
Congenital disorders with intellectual disability (ID) constitute a particularly significant medical
problem because of the high prevalence and life–long care that patients will need. The extreme
genetic heterogeneity of ID is a major problem for pre– and postnatal diagnosis. In some cases,
however, early detection of a mutation may be important to prevent the manifestation of the
handicap (Avbelj et al. 2007). Congenital hypothyroidism (CH) is one of the most frequent causes of
preventable ID, which can be averted by administering thyroid hormone in early postnatal life. This
is achieved by newborn screening detection.
Congenital hypothyroidism fulfills most of the criteria for disease screening as set out by Wilson
and Jungner (Wilson and Jungner 1968), in fact CH is four to five times more common than
Phenylketonuria for which newborn screening was initially developed (Chiesa, Rivolta, Targovnik,
& Gruneiro–Papendieck 2010).
Detection of CH by neonatal screening has been a major achievement because early diagnosis and
treatment result in normal development in nearly all cases. An additional benefit of neonatal
screening has been the elucidation of the incidence of CH as well as the prevalence of its various
causes.
The incidence rate of CH is approximately 1 of 3000/4000 new births worldwide (Calaciura,
Miscio, Coco, Leonardi, Cisternino, Regalbuto, Bozzali, Maiorana, Ranieri, Carta, Buscema,
Trischitta, Sava, & Tassi 2002). However, this

Venture Screening
.
Venture Screening
BUS604
June 3, 2012
My business idea is to have light weight compact exercising equipment that can be move from place
to place without taking up too much space or being to heavy to carry. My venture will be to promote
good and healthy habits that will include a daily work out with a multi– purpose unit. This unit will
be sold in the United States and abroad it will have a reasonable price of fifty dollars per unit it will
be advertised on infomercials and online (Barringer, Ireland2006).
The essential components are the needs of the customer, pricing, and value creation proposition,
marketing niche and product mix. If the consumer feels that this machine meets, their needs as far as
being easy to carry, ... Show more content on Helpwriting.net ...
In conclusion, having an idea and putting it into action takes more than just words on paper you
have to do your home work and hit the ground running so that you can get recognized then you let
your products and good customer service do the rest (Davison 2006). The essential components are
the needs of the customer, pricing, and value creation proposition, marketing niche and product mix.
A screening of the new venture will identify potential markets abroad competitive advantages are
low fixed costs, control over costs and location .An opportunity has been screened for exporting of
compact exercising equipment to other countries the venture is promising. New business processes
along with new technology will provide exercising equipment to small gyms in many places abroad.
The economics of this venture is low capital and free cash flow this venture will break even in
maybe 12 months. This venture has a good fit with long term goals one of those goals will be having
a bilingual team within two years of the venture.
Good customer service will set my company apart from the strategic differentiation of my
competitors also use of technology, pricing, and quality products. When I start my new venture with
my exercising unit, I want people to know just how well my product works.
Reference:
Davison,

Diagnosis And Treatment Of Prostate Cancer
When we have diseases or don't feel well, we tend to seek treatments and try to cure it as soon as
possible. However, what if there is no reliable treatment or nearly no treatment available? Then, the
only option is to do research. Life can be really difficult and no one wants any sickness or diagnosed
with such a hard–to–cure disease like cancer. Prostate Cancer is a known cancer that happens to
men only and a lot of men in the U.S are diagnosed with it, and happens to male's reproductive
system. Specifically speaking, it is a gland found in the most private area of a man. In the following
paragraphs, I will be explaining why we need to find a way to combat prostate cancer, how to detect
this cancer at early stages, and the risks associated with prostate cancer.
Prostate cancer is the second leading cause of death by cancer for men in the U.S. It mostly affects
African– American men than men of other races. In addition, those men who suffer from prostate
cancer would not know that they are affected until they participate in a health checkup or conduct
self–diagnoses. A healthy prostate gland should be about the size of a walnut or smaller depend on
individuals. According, to a cancer research center stated about why men are more likely to get
cancer "... men were more likely to die from any of the cancers investigated in the report, and ...
were also more likely to develop the disease in the first place" (Arney, 2009). Also, men are more
likely to die from any kind of cancer

Cytological Screening
The focus of this essay is on the process that takes place in the pathology laboratory, where the
cervical samples are sent for cytological screening. A cervical cell sample that has no abnormal cells
is categorised cytologically as being negative (negative for the presence of HPV or risk of cervical
cancer). Alternatively, samples may be identified as containing borderline abnormal changes, or
having dyskaryosis (Health and Social Care Information Centre, 2013). In some literature the terms
dysplasia or CIN (cervical intraepithelial neoplasia) seem to be used in place of dyskaryosis (Eifel et
al., 2011), but NHS literature seems to make most consistent reference to dyskaryosis. The extent of
dyskaryosis is then classified across a range from ... Show more content on Helpwriting.net ...
The aim of this new method was initially to try to reduce false–negative and false–positive results
(Karnon et al., 2004; Siebers et al., 2009), as well as the number of samples that are 'inadequate' or
'unsatisfactory' for effective screening (Arbyn et al., 2008; Siebers et al., 2009). In the conventional
cytology method, a woman's cervical sample is transferred directly from the collection spatula onto
a microscopic slide (Arbyn et al., 2008; Moss et al., 2003). This transfer process seems to
sometimes lead samples to be 'inadequate' for screening because the transferred cells are too
difficult to clearly discern. This manual process does also, very occasionally, result in false results,
even when conducted by experienced cytologists. The liquid based cytology (LBC) method involves
a slightly different approach to the preparation of the slides. The cell sample is placed into a vial
containing a preservative fluid (Arbyn et al., 2008; Moss et al., 2003). This creates a liquid
suspension of the sample, which can then be poured onto the slide in a very thin, uniform layer.
However, debate remains over whether this method really offers a substantial improvement over
conventional cytology. The main points of contention surround accuracy and cost effectiveness, with
other arguments relating to patient anxiety and opportunities for HPV

CCHD Screening
Theoretical and Ethical Basis of Practice Nursing theories and ethical principles serve as the
foundation of nursing practice, education, and research (Colley, 2003; Antipuesto, 2011). This
paper's purpose is to elaborate on the author's discussion of her phenomenon of interest (POI) on
newborn screening for Critical Congenital Heart Defects (CCHD). The objectives of this paper are
to discuss the metaparadigm of nursing as it relates to the author's POI, to discuss the Neuman
system model and discuss the POI within its framework, to discuss the inter–related concepts in the
UCSF symptom management model and associate it with the Neuman system model, examine the
POI as it relates to the complexity science framework, and to distinguish ethical ... Show more
In the author's POI, the newborn being screened for CCHD is the person component of nursing
metaparadigm. The environment component is the place where the newborn was born. In this case,
the environment's altitude has an impact on the results of newborn screening for CCHD. In a study
done by Ravert, Detwiler, and Dickinson (2011), they stated that the oxygen saturation readings are
lower on newborns delivered at higher altitudes than those born at sea level. Because of the effect of
altitude in oxygen saturation readings, Ravert, Detwiler, & Dickinson suggested that there is a need
to modify the newborn screening algorithm for CCHD in places that are located in higher altitudes.
The health aspect of the nursing metaparadigm in the author's POI is demonstrated by the degree of
the newborn's wellness at the time CCHD is detected. The health status of the newborn during the
time of diagnosis has a direct correlation to the outcomes of interventions. According to Martin,
Kemper, and Bradshaw (2012), when newborns with CCHD are diagnosed late, and they are already
critically ill when they present, the prognosis for interventions are worse as opposed to the
newborns whose cardiac defects were detected early while the newborn is still doing well. Lastly,
the nursing component of the metaparadigm in the author's POI is exhibited by nursing participation
in the interdisciplinary collaborative efforts when

Genetic Studies Of Prostate Cancer
Background: Among various epithelial cancers, genomic studies of prostate cancer (PCa) identified
several molecular markers including E26 transformation specific (ETS) gene fusions, SPINK1 and
many others. The prevalence of these molecular markers in African American (AA) prostate cancer
has not been studied to the extent that has been studied for European American (EA) prostate cancer
to understand the racial disparity. Contrary to the conventional approaches, new approaches are
needed to understand the underlying genetic disparity between the AA and EA PCa. Therefore, we
have developed refined approaches to screen whole–mount radical prostatectomy tissues rather than
systematic sampling of tumor from dominant/index nodule to assess the fundamental molecular
differences in the incidence of molecular markers between AA and EA prostate cancer.
Hypothesis/Objective: Prostate molecular markers have been first discovered using the cancer
genome of individuals other than African American decent. Due to the lack of screening in a large
cohort of AA PCa the prevalence of these markers in AA PCa is not known. Given the fundamental
differences in the ancestral history of the genome of AA and EA the prevalence of these molecular
markers may be markedly different. Conventional systematic sampling approaches may not reveal
the true prevalence in AA PCa. Therefore, we propose to undertake an innovative approach using
whole–mount radical prostatectomy to understand the racial disparity.

One of the reasons that people often receive a late prostate cancer diagnosis is because they may
notice any signs. Most people do not notice any enlarged prostate symptoms until the cancer is
advanced. There are a number of prostate cancer signs & symptoms a person may notice if he is in
the advanced stages. Below is a list of prostate cancer symptoms:
Prostate Cancer And The Urethra
Prostate cancer affects the urethra and the bladder. That is why men who have prostate cancer are
likely to have urinary problems. They may have to get up frequently in the middle of night to go to
the restroom. It is also common for a man with prostate cancer to experience a burning sensation
while urinating.
The prostate cancer urinary stream may be weak.

Detriment of PSA Screening Essay
Arguably the most essential and indispensable aspect of life is the attainment and preservation of
good health. Individuals with health–related complications are often prevented from leading what
many would consider to be a normal lifestyle. One of the several ailments that impedes typical
human functioning is prostate cancer. The community of experts and professionals who have
dedicated their lives to this field of study are, at this time, engaged in a substantive yet divisive and
strongly opinionated dispute regarding a test considered by some to aid in the detection of this
cancer. This highly scrutinized test is known as the prostate–specific antigen test, more commonly
referred to as the PSA test. In the United States and more broadly ... Show more content on
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In a fairly easy to follow rankings system or grading scale, this government health body had
previously given the PSA procedure an "I" grade; in other words, the screening was thought of as
inconclusive and neither the harm nor benefit could be proven by either side. In the new report, a D
grade is imparted upon the screening which signifies that it is thought of in such a negative light that
the panel recommends and advises against the test. Not many routine tests of this nature are given
such a poor status; this fact should and does lead many physicians away from the regular
administration of the screening. Not only is this test ill–advised by the U.S. Preventative Services
Task Force, it has also been looked down upon in the past, in a sense, by various other respected and
knowledgeable medical organizations. For example, both the American Cancer Society and the
American Urological Association have taken a stance in opposition to routine prostate–specific
antigen screenings. Using the exact scale as the one employed by the United States Preventative
Services Task Force, these two organizations have given the PSA test a C grade; this status simply
means that although they believe the interaction and dialogue between patient and physician to be
crucial to

Screening For Glaucoma
According to the article Screening for Glaucoma: U.S. Preventive Services Task Force
Recommendation Statement "glaucoma affects approximately 2.5 million Americans and is a
leading cause of impaired vision (loss of peripheral vision) and blindness" (Moyer). Glaucoma is a
disease the damages the optic nerve in the eye. There are several different types of glaucoma
including: Open–angle, normal–tension, closed–angle, and congenital glaucoma. Open–angle is the
most common. Even though there is no treatment yet for glaucoma, a person can manage it. To help
a person mange this disease there are two basic treatments that can be used: medicated eye drops or
surgery. Glaucoma is an eye disease that affects the optic nerve in the eye and can cause ... Show
"Marijuana has been proven to lower IOP but only for a short period of time and at considerable risk
to your overall health" (Turbert). When smoking marijuana the active ingredient THC in some way
has been proven to lower eye pressure levels. "In 4 hours, the pressure–lowering effect of marijuana
is gone. To maintain continuous control of IOP, avoiding unhealthy peaks and valleys, it would be
necessary to smoke a joint about every 1 to 2 hours. That's several thousand cigarettes a year"
(Scerra). Even though it may seem like a good idea to help lower the pressure in an eye it may not
be the most effective way in treating glaucoma. Since glaucoma needs to be treated around the clock
"you would need to smoke marijuana six to eight times a day around the clock to receive the benefit
of a consistently lowered IOP" (Kern). Since, this drug has altering affects to the body it may not be
the most appropriate of choices to use to help

Digital Screening
As of 2017, breast cancer is the second most common cause of death in women. Around the globe
about 1.3 million women are diagnosed with breast cancer after their biennial mammographic
digital screening.5 Considering this, breast cancer is one of the most common forms of cancer in the
world. Digital mammograms are taken of the breast to detect any form of a tumor. People tend to
believe that the Radiologist looks at their picture and determines whether a tumor is present.
However, there are several types of systems that are designed to detect certain forms of breast
cancer in certain areas after a screening has taken place. Essentially, the MRI screening is sent into a
digital processing system to highlight any areas that might be forming ... Show more content on
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The CS took about 12.0 minutes and the DC took about 12.71. The comparison of evaluation times
is significantly the same.
The second comparison between the CS and DC is image quality. Image quality is extremely
important in every aspect of Radiology; however, it is drastically important in breast imaging. This
is mainly because cancer in the breast is sometimes extremely small and very hard for the human
eye to see. Excellent image quality can show anything from tumors to fractures. According to a
performance study, the CADstream and DynaCAD provides higher image quality. They concluded
this fact by having 10 Radiologists who had 4–6 years of experience run patient screenings that
were difficult to read through the CS and DC. They scored the CS and DC on a scale of 0–5. Once
those scores were compared, the two systems only had a 0.05 difference1.
The last comparison between the two systems is what helps the radiologist improve a difficult
diagnosis. Specifying whether a tumor is malignant or benign can be difficult in some cases.
Therefore, the CS and DC point out distinctive characteristics of a malignant or benign tumor. A
study was shown to prove that the CS and DC systems most often can differentiate tumors at the
same rate. Multiple difficult images were passed through each system to see if their evaluations
were

Health Belief Model Prostate Cancer
Introduction According to Anderson and Marshall–Lucette (2016), prostate cancer is the second
leading cause of deaths in developed countires with the highest incidence in diagnoses for males
worldwide. (p1046) "African American men have the highest incidence of prostate cancer, with a 1
in 5 probability of getting prostate cancer with the lowest rate of participation in prostate cancer
screening. (Sandiford & D'Errico, 2015, p.86) The Health Belief Model was constructed to help
understand behavior and reasons for noncompliance with medical care and actions. Nurses and
healthcare professionals can use the information to help develop a model regarding prostate cancer
screening that will educate patients, promote health, help prevent disease ... Show more content on
Helpwriting.net ...
Educating males on the severity of prostate cancer in their culture and the importance in screening
for the condition can save many lives. It is our job, as healthcare professionals, to provide this
patient population with a means and strategy capable of reducing the prevalence of prostate cancer.
Many men are not aware but routine screening should start when one reaches his 50's or 40's if he is
from a high–risk group or has a family history of the disease. (Sandiford, L., & D'Errico, E. 2016,
p86) According to Anderson & Mashall–Lucette (2016), African American men are disinclined to
participate in screening programs due to fear that the digital rectal exam can lead to homosexuality
or changes in masculinity, a diagnosis may be discovered, lack of knowledge surrounding the
diagnosis and family history, socioeconomic status, changes in one's sex life, and developing sexual
or urinary dysfunction.

Diagnostic Screening
High blood pressure (hypertension):(systolic blood pressure 140 or more and/or Diastolic blood
pressure 90 or more) is 35.6% respectively, being higher among men (36.5%) than women (34.5%).
High level glycaemia (Hyperglycemia): (fasting blood glucose 7mmol/L or higher) is13.9%
respectively, being higher among men. One third of high blood pressure and half with diabetes are
unknown of their condition. Screening is defined as the presumptive identification of unrecognized
disease or defects by the application of tests, examinations, or other procedures that can be applied
rapidly. The qualifier presumptive is included in the definition(11) to emphasize the preliminary
nature of screening; diagnostic confirmation is required, usually with the benefit of more thorough
clinical examination and additional ... Show more content on Helpwriting.net ...
Some screening programs are conducted in order to screen interested and concerned individuals for
specific health problems, such as hypertension, cervical cancer, or sickle–cell disease. An example
of this type of screening program would be administration of a free thyroid test (serum level of
thyroxine) to passersby in a shopping center or members of a senior citizens center.5 Other
screening programs may be applied on a mass basis to almost all individuals in the population; an
example is screening for phenylketonuria (PKU) among all neonates. It should be noted that
screening differs from diagnosis, which is the process of confirming an actual case of a disease.
(12,13) As a result of diagnosis, medical intervention, if appropriate, is

Vision Screening
It is estimated that one in four children need to wear prescription glasses. A vision screening can
confirm whether your child needs glasses. However, there are a number of signs you may notice if
your child has a vision problem. Below is a list of signs that your child needs glasses: Squinting
Squinting is one of the most common signs of vision problems in children. The reason children
squint when they have vision problems is because it can help bring a blurry object into focus.
Squinting slightly changes the shape of the eyes. Sitting Too Close To The TV It is common for
children to sit too close to the computer or television. However, if your child is making a habit out
of sitting too close to the computer or TV, then this could be a

Prostate Cancer Physiotherapy
Prostate cancer is now the most common cancer in men in the UK and the second highest cause of
male cancer death. Yet despite its high prevalence it is also highly survivable, with figures from
Cancer Research UK showing that 84 per cent of men diagnosed with the disease survive ten years
or more following treatment.
With such a high survival rate would be easy to assume that the needs of this patient group are being
adequately met. But this isn't the case, says specialist prostate cancer physiotherapist Helen
Whitney.
'Research on men's health behaviours has shown that men are more hesitant than women about
seeking support or advice about their health,' she explains.
'They may have cancer needs and physical symptoms but they don't always ... Show more content
on Helpwriting.net ...
'We are looking into the possibility of running a research trial to see if it has a clinical impact,' she
explains.
Outcomes and impact
The project has produced impressive results. In the last six months more than 140 men have
attended the physiotherapy sessions and the health and wellbeing clinics have proved popular; the
most recent one attracting more than 40 men and their partners.
The initiative has also helped raise the profile of physiotherapy and promoted its value for prostate
cancer patients, says Ms Whitney.
Since it began she has delivered 15 education sessions to community health teams and oncologists,
clinical nurse specialists and commissioners.
'As result we have tripled the number of men being seen by the physio outpatient service,' she says.
The latest project analysis figures reveal that six months after their initial assessment men
participating in the pilot had increased their physical activity level by an average of 209 per

Signs and Symptoms of Prostate Cancer
Unlike many other cancers and serious health problems, prostate cancer does not usually show its
symptoms during the earlier stages of its development. This can make it a lot more dangerous than
many other cancers and in the US; it ranks amongst the top four most commonly diagnosed cancers
(alongside breast, colorectal and lung).
How is prostate cancer diagnosed and detected?
Once again, unlike most cancers the signs of prostate cancer can develop very differently in each
individual male as the cause of the cancer can also vary greatly. Due to these wide ranges of causes
and symptoms, a number of different screening procedures may be required to clear or diagnose
someone with prostate cancer. These screening

A Short Note On Health And Dental Insurance
Health History Date: August 15th Name: Mr. ZNK Address: 1121 Maryland Avenue, Beltsville, MD
20707 Telephone: 3016554386 Age: 30 Date of birth: April 24,1984 Birthplace: Accra, Ghana
Gender: Male Marital status: Single Race: African Religion: Non Occupation: Automotive
technician Health insurance: Medical & dental insurance from work Source: Client Reliability:
Client is alert to person, place ,situation, and time and is able to provide needed information during
assessment Present Health/Illness Reason for seeking care: Medical checkup for frequent urination
that started one week ago. Urine amount each time is very small. Daily activities get interrupted and
"I am hesitant to drink fluids but that has not prevented it". Health beliefs and practices: Visit the
doctor as often as possible, especially if I feel like something is not right in my body. Health
patterns: Try to eat right and exercise regularly Medications: No medications. Tylenol once in
awhile for headache Health goals: Work on having annual checkup with my doctor Past History
Childhood illnesses: Chicken pox, measles and asthma Immunizations: Had all the childhood
vaccines in Accra. Other vaccines like hepatitis vaccine I had in the US Medical illnesses: History
of asthma and seasonal flu Hospitalization: None Surgery: None Injury: Sustained a laceration on
scalp at age 10 and had a suture. Blood transfusion: None Emotional/psychiatric problems: I get
overwhelmed at times with pressure

Screening Twilight
The first idea or theme pertaining to the masochistic nature of Twilight is in the physical dangers
and eroticized pain characterizing Bella's relationship with Edward. Bella is complicit in this
relationship wherein she places herself in a supposedly weaker and dependent position in relation to
Edward. There is not one example of a time that Bella is in trouble or in pain and Edward is not
there to save her in some way. Bella's reliance on Edward begins with him saving her from the
runaway car; the amount of times he saves her implies her inability to exist in the most mundane
way without his particular guardianship. Another example of Edwards guardianship is when Bella is
having nightmares he stands over her at night to watch her and make sure no harm comes to her,
even sleeping make Bella vulnerable and Edward sees that. One last example of this ... Show more
These roles of power and submission also seem to repeat deeply problematic conservative attitudes
towards gender, sexual power and male dominance according to "Screening Twilight," a novel by
Clayton and Harman. Edward has the power in the relationship because he is immortal, he is a
vampire, he has the strength of 1000 men, and he has complete control over Bella. Bella who is the
submissive one because she is weak in body and in mind, she lets her emotions and feeling toward
Edward rule her every move and she would quite literally do anything for her. A scene in the movie
where Bella first discovers Edward's true nature and that he is a vampire cements this idea. He
explains that he has killed people and that he has the ability and the urge to kill her. Bella responds
by saying that she isn't afraid of anything he has told her, he is only afraid of losing him because she
feels like he is so afraid of himself around her that he will

Characteristics Prostatic Specific Antigen ( Psa )
5.0 Laboratory Tests
5.1 Prostate Specific Antigen (PSA)
Table 2: Summary of characteristics Prostatic Specific Antigen (PSA)
Characteristic Data Comments
Classification PSA is a glycoprotein produced by the prostate epithelial cells Cancer may elevate
levels both from increased production and because tissue barriers between the gland lumen and
vascular bed are disrupted.
PSA Levels PSA has a half–life of 2.2 days and elevated levels vary in recovery depending on the
cause of the elevation PSA elevation may precede clinical cancer by 5 –10 years.
Specificity PSA is organ specific, not cancer specific. Using 4.0 ng/ml as cut–off for abnormal the
specificity is 91% and 85% for cut–off of 3.0 ng/ml Elevated levels also found in BPH and
prostatitis/UTIs, post prostate biopsy and in acute urinary retention (do not test for 2–4 weeks).
Negligible level increases due to DRE.
Sensitivity Most screening studies use 4.0 ng/ml as cut–off for abnormal levels, but a review of the
literature in 2006 showed the estimated sensitivity using 4.0 was only 21% for detecting cancer and
51% for detecting high grade (Gleason >8). In 2009, estimates of 4.3 to 73% sensitivity were given
(www.parliament.nz/resource0000166364). Using 3.0 cut–off increased sensitivities to 32 and 68%.
(Arch Ital Androl 1006 78 (4) 125–9) Cancer may be present with "normal" PSA levels, and a PSA
level may not correlate with the acuity of the prostate cancer. A later study concluded that no single
cut–off for PSA

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