The case involves a dispute between family members over withdrawing life support for Mrs. B, who was comatose for 1 month and had multiple chronic illnesses. Her husband reluctantly asked the doctor to withdraw care in accordance with her prior wishes, but one daughter disputed this. The medical team was trying to revive her condition. This poses an ethical dilemma over honoring the patient's prior wishes versus a family member's objections.
First do no harm pp presentation for general usegranny_annie1953
This is a PowerPoint presentation summarizing the unethical, immoral and illegal acts of the power-hungry hiererarchy at the Burntwood Regional Health Authority in Northern Manitoba.
First do no harm pp presentation for general usegranny_annie1953
This is a PowerPoint presentation summarizing the unethical, immoral and illegal acts of the power-hungry hiererarchy at the Burntwood Regional Health Authority in Northern Manitoba.
When the faith rubber meets the road mile 3Donald Jacobs
This is the third in the series of Slideshares that chronicle the last month of my beautiful wife, Ruth's life. It will show the love that we had for each other and our trust in God. Ruth is now with the Lord but her memory remains with me and the countless others whose lives she touched. I love you Ruth
This is a very touching story of Michaella. Agaist all ods, Michaella grows up to be a strong a beautiful young lady. She loves to play all sports, especially soccer. She has no fear at!!!! I am proud of you, Michealla!
Suzzete, thank to a you; a wonderful mother.
Patient Voices Network Forum: Consumer Health 2.0 HandoutDaniel Hooker
"Consumer Health 2.0: Using social media to find and share health information." A handout of supplemental information and activities to support the presentation given to the Patient Voices Network Forum, "Voices in Action" on April 16, 2011.
For this assignment, consider the following case and then using th.docxbudbarber38650
For this assignment, consider the following case and then using the internet, course materials, and the Library, compose reasoned responses to the questions that follow.
In the mid 1970s, a nursing educator in Idaho had contact, through a student, with a female client who had chronic myelogenous leukemia. This form of leukemia can often be managed for years with little or no chemotherapy. The woman had done well for about twelve years and ascribed her good condition to health foods and a strict nutritional regime. However, her condition had turned worse several weeks before and her physician had advised her that she needed chemotherapy if she were to have any chance at survival. The physician had also advised her of the potential side effects of the therapy including hair loss, nausea, fever, and immune system suppression.
The woman consented to the therapy and signed the appropriate forms, but later, she began to have second thoughts. The nursing educator and student had given the patient one dose of the therapy when the woman began to cry and express her reservations about the therapy. She questioned the nurse about alternative treatments to the use of chemotherapy. The patient related that she had accepted the therapy because her son had advised her that this was the best treatment. She related that she had not asked about alternate forms of treatment as the physician had indicated that chemotherapy was the only treatment indicated. The nurse did not discuss the patient's concerns with the physician, and later that evening, she talked to the patient about alternate therapies. In the discussion, rather nontraditional and controversial therapies were covered including reflexology and the use of laetrile. During the talk, the nurse made it very clear that the treatments under discussion were not sanctioned by the medical community.
The patient's feelings toward alternate therapies were strengthened by the evening's conversation; however, she continued with chemotherapy. The treatments, however, did not bring remission to her crisis and she died two weeks later. Upon hearing about the conversation between the off duty nurse educator and his patient, the physician brought charges against the nurse for unprofessional conduct and interfering with the patient-physician relationship. (In re Tuma, 1977).
1. What, if anything, did the nurse do wrong?
2. Had she moved beyond her scope of practice?
3. Could the nurse's conduct be justified under the patient advocate portion of her role?
4. If you were a member of the state board for nursing and had to decide the issue of unprofessional conduct and interference with the patient-physician relationship, would you sanction the nurse?
Support your responses with evidence and cite your sources.
Length 4 pages not counting the case. At least 4 references; scholarly sources
COURSE MATERIAL INFORMATION
: Ethical Principles and Dilemmas of Confidentiality, Veracity, and Fidelity
Health care .
T he fifteen year-old patient was scheduled for surgery on t.docxlillie234567
T he fifteen year-old patient was
scheduled for surgery on the right
side of his brain to remove a right tem-
poral lobe lesion that was believed to be
causing his epileptic seizures.
The surgery began with the sur-
geon making an incision on the left
side, opening the skull, penetrating the
dura and removing significant portions
of the left amygdala, hippocampus and
other left-side brain tissue before it was
discovered that they were working on
the wrong side.
The left-side wound was closed,
the right side was opened and the pro-
cedure went ahead on the right, correct
side.
The error in the O.R. was revealed
to the parents shortly after the surgery,
but only as if it was a minor and incon-
sequential gaffe.
The patient recuperated, left the
hospital, returned to his regular activi-
ties and graduated from high school
before his parents could no longer deny
he was not all right. After a thorough
neurological assessment he had to be
placed in an assisted living facility for
brain damaged individuals.
When the full magnitude of the
consequences came to light a lawsuit
was filed which resulted in a $11 mil-
lion judgment which was affirmed by
the Supreme Court of Arkansas.
A circulating nurse has a le-
gal duty to see that surgery
does not take place on the
wrong side of the body.
The preoperative documents
failed to identify on which side
the surgery was to be done.
It was below the standard of
care for the circulating nurse
not to notice that fact and not
to seek out the correct infor-
mation.
SUPREME COURT OF ARKANSAS
December 13, 2012
Operating Room: Surgical Error Blamed, In
Part, On Circulating Nurse’s Negligence.
Surgical Error Blamed, In Part, On
Circulating Nurse’s Negligence
The Court accepted the testimony
of the family’s nursing expert that a
circulating nurse has a fundamental
responsibility as a member of the surgi-
cal team to make sure that surgery is
done on the correct anatomical site,
especially when it is brain surgery.
The circulating nurse is supposed
to understand imposing terms like se-
lective amygdala hippocampectomy
and know the basics of how it is sup-
posed to be done.
Hospital policy called for the sur-
geon, the anesthesiologist, the circulat-
ing nurse and the scrub nurse or tech to
take a “timeout” prior to starting a sur-
gical case for final verification of the
correct anatomical site.
The circulating nurse should have
available three essential documents, the
surgical consent form, the preoperative
history and the O.R. schedule.
The full extent of the error, that is,
a full list of the parts of the brain that
were removed from the healthy side,
should have been documented by the
circulating nurse, and failure to do so
was a factor that adversely affected the
patient’s later medical course, the pa-
tient’s nursing expert said. Proassur-
ance v. Metheny, __ S.W. 3d __, 2012 WL
6204231 (Ark.
I had a near death experience due to lack of timely treatment on necrosis which was caused due to abdominoplasty without liposuction. The ppt explained the series and are meant to be informative.
When the faith rubber meets the road mile 3Donald Jacobs
This is the third in the series of Slideshares that chronicle the last month of my beautiful wife, Ruth's life. It will show the love that we had for each other and our trust in God. Ruth is now with the Lord but her memory remains with me and the countless others whose lives she touched. I love you Ruth
This is a very touching story of Michaella. Agaist all ods, Michaella grows up to be a strong a beautiful young lady. She loves to play all sports, especially soccer. She has no fear at!!!! I am proud of you, Michealla!
Suzzete, thank to a you; a wonderful mother.
Patient Voices Network Forum: Consumer Health 2.0 HandoutDaniel Hooker
"Consumer Health 2.0: Using social media to find and share health information." A handout of supplemental information and activities to support the presentation given to the Patient Voices Network Forum, "Voices in Action" on April 16, 2011.
For this assignment, consider the following case and then using th.docxbudbarber38650
For this assignment, consider the following case and then using the internet, course materials, and the Library, compose reasoned responses to the questions that follow.
In the mid 1970s, a nursing educator in Idaho had contact, through a student, with a female client who had chronic myelogenous leukemia. This form of leukemia can often be managed for years with little or no chemotherapy. The woman had done well for about twelve years and ascribed her good condition to health foods and a strict nutritional regime. However, her condition had turned worse several weeks before and her physician had advised her that she needed chemotherapy if she were to have any chance at survival. The physician had also advised her of the potential side effects of the therapy including hair loss, nausea, fever, and immune system suppression.
The woman consented to the therapy and signed the appropriate forms, but later, she began to have second thoughts. The nursing educator and student had given the patient one dose of the therapy when the woman began to cry and express her reservations about the therapy. She questioned the nurse about alternative treatments to the use of chemotherapy. The patient related that she had accepted the therapy because her son had advised her that this was the best treatment. She related that she had not asked about alternate forms of treatment as the physician had indicated that chemotherapy was the only treatment indicated. The nurse did not discuss the patient's concerns with the physician, and later that evening, she talked to the patient about alternate therapies. In the discussion, rather nontraditional and controversial therapies were covered including reflexology and the use of laetrile. During the talk, the nurse made it very clear that the treatments under discussion were not sanctioned by the medical community.
The patient's feelings toward alternate therapies were strengthened by the evening's conversation; however, she continued with chemotherapy. The treatments, however, did not bring remission to her crisis and she died two weeks later. Upon hearing about the conversation between the off duty nurse educator and his patient, the physician brought charges against the nurse for unprofessional conduct and interfering with the patient-physician relationship. (In re Tuma, 1977).
1. What, if anything, did the nurse do wrong?
2. Had she moved beyond her scope of practice?
3. Could the nurse's conduct be justified under the patient advocate portion of her role?
4. If you were a member of the state board for nursing and had to decide the issue of unprofessional conduct and interference with the patient-physician relationship, would you sanction the nurse?
Support your responses with evidence and cite your sources.
Length 4 pages not counting the case. At least 4 references; scholarly sources
COURSE MATERIAL INFORMATION
: Ethical Principles and Dilemmas of Confidentiality, Veracity, and Fidelity
Health care .
T he fifteen year-old patient was scheduled for surgery on t.docxlillie234567
T he fifteen year-old patient was
scheduled for surgery on the right
side of his brain to remove a right tem-
poral lobe lesion that was believed to be
causing his epileptic seizures.
The surgery began with the sur-
geon making an incision on the left
side, opening the skull, penetrating the
dura and removing significant portions
of the left amygdala, hippocampus and
other left-side brain tissue before it was
discovered that they were working on
the wrong side.
The left-side wound was closed,
the right side was opened and the pro-
cedure went ahead on the right, correct
side.
The error in the O.R. was revealed
to the parents shortly after the surgery,
but only as if it was a minor and incon-
sequential gaffe.
The patient recuperated, left the
hospital, returned to his regular activi-
ties and graduated from high school
before his parents could no longer deny
he was not all right. After a thorough
neurological assessment he had to be
placed in an assisted living facility for
brain damaged individuals.
When the full magnitude of the
consequences came to light a lawsuit
was filed which resulted in a $11 mil-
lion judgment which was affirmed by
the Supreme Court of Arkansas.
A circulating nurse has a le-
gal duty to see that surgery
does not take place on the
wrong side of the body.
The preoperative documents
failed to identify on which side
the surgery was to be done.
It was below the standard of
care for the circulating nurse
not to notice that fact and not
to seek out the correct infor-
mation.
SUPREME COURT OF ARKANSAS
December 13, 2012
Operating Room: Surgical Error Blamed, In
Part, On Circulating Nurse’s Negligence.
Surgical Error Blamed, In Part, On
Circulating Nurse’s Negligence
The Court accepted the testimony
of the family’s nursing expert that a
circulating nurse has a fundamental
responsibility as a member of the surgi-
cal team to make sure that surgery is
done on the correct anatomical site,
especially when it is brain surgery.
The circulating nurse is supposed
to understand imposing terms like se-
lective amygdala hippocampectomy
and know the basics of how it is sup-
posed to be done.
Hospital policy called for the sur-
geon, the anesthesiologist, the circulat-
ing nurse and the scrub nurse or tech to
take a “timeout” prior to starting a sur-
gical case for final verification of the
correct anatomical site.
The circulating nurse should have
available three essential documents, the
surgical consent form, the preoperative
history and the O.R. schedule.
The full extent of the error, that is,
a full list of the parts of the brain that
were removed from the healthy side,
should have been documented by the
circulating nurse, and failure to do so
was a factor that adversely affected the
patient’s later medical course, the pa-
tient’s nursing expert said. Proassur-
ance v. Metheny, __ S.W. 3d __, 2012 WL
6204231 (Ark.
I had a near death experience due to lack of timely treatment on necrosis which was caused due to abdominoplasty without liposuction. The ppt explained the series and are meant to be informative.
Question What is the ethical dilemma that arises from this clinical.pdfAlphaVision2
Question: What is the ethical dilemma that arises from this clinical case? Pls explain long and
with references.
Nurses face more and more ethical dilemmas during their practice nowadays,
especially when taking care of the patient at the end of the life stage.
Ethical dilemma identification: The ethical dilemma is if the nursing staff should tell
other health care team members about a patient's suicide attempt without the
patient's consent.
To solve this case and make the best moral decision, the ethical theory, the ethical
principles, and the nurses' code of ethics values statement, the associated literature
relative to this case, are analyzed before making decisions.
The patient, Mr. Green, is a 57-year-old gentleman with aggressive prostate cancer
who is cared for by the nursing team in the oncology department of Cortellucci
Hospital. Mr. Green was diagnosed with prostate cancer seven years ago but
refused medical and surgical treatment at the time. He chose to seek alternative
treatment and did not follow up with the urologist over those seven years. Mr.
Green has now presented with anemia and hypoproteinemia. After several
diagnostic tests, it was discovered that the cancer had metastasized to his bones
and spread locally to his lymph nodes. The primary tumour was invading the
bladder and partially obstructing the left kidney.
Mr. Green had several admissions over two months for various reasons. On the last
admission, Mr. Green was told that he might only have 4 - 6 weeks (previously, it
was 6 - 12 months) to live after a cystoscopy showed further extensive growth of
the tumour. It was determined that further surgical/medical intervention would not
be appropriate in this case and that a palliative care regimen was the next step. At
this point, the patient reported to the healthcare team that he had resigned himself
to the fact that he was going to die.
Mr. Green pulled you aside and confided that he planned to kill himself and that it
was a secret that you were not to tell anyone.
Nurses face more and more ethical dilemmas during their practice nowadays,
especially when taking care of the patient at the end of the life stage.
Ethical dilemma identification: The ethical dilemma is if the nursing staff should tell
other health care team members about a patient's suicide attempt without the
patient's consent.
To solve this case and make the best moral decision, the ethical theory, the ethical
principles, and the nurses' code of ethics values statement, the associated literature
relative to this case, are analyzed before making decisions.
The patient, Mr. Green, is a 57-year-old gentleman with aggressive prostate cancer
who is cared for by the nursing team in the oncology department of Cortellucci
Hospital. Mr. Green was diagnosed with prostate cancer seven years ago but
refused medical and surgical treatment at the time. He chose to seek alternative
treatment and did not follow up with the urologist over those seven years. Mr.
Green has now.
Question Why it is important to consider this case from an ethical .pdfsunilkhetpal
Question: Why it is important to consider this case from an ethical standpoint? According to the
CNA code of ethics. what ethical values should the nurse consider when communicating with
Mr. Green and her supervisor? Pls explain in 2 pages and with references.
Nurses face more and more ethical dilemmas during their practice nowadays,
especially when taking care of the patient at the end of the life stage.
Ethical dilemma identification: The ethical dilemma is if the nursing staff should tell
other health care team members about a patient's suicide attempt without the
patient's consent.
To solve this case and make the best moral decision, the ethical theory, the ethical
principles, and the nurses' code of ethics values statement, the associated literature
relative to this case, are analyzed before making decisions.
The patient, Mr. Green, is a 57-year-old gentleman with aggressive prostate cancer
who is cared for by the nursing team in the oncology department of Cortellucci
Hospital. Mr. Green was diagnosed with prostate cancer seven years ago but
refused medical and surgical treatment at the time. He chose to seek alternative
treatment and did not follow up with the urologist over those seven years. Mr.
Green has now presented with anemia and hypoproteinemia. After several
diagnostic tests, it was discovered that the cancer had metastasized to his bones
and spread locally to his lymph nodes. The primary tumour was invading the
bladder and partially obstructing the left kidney.
Mr. Green had several admissions over two months for various reasons. On the last
admission, Mr. Green was told that he might only have 4 - 6 weeks (previously, it
was 6 - 12 months) to live after a cystoscopy showed further extensive growth of
the tumour. It was determined that further surgical/medical intervention would not
be appropriate in this case and that a palliative care regimen was the next step. At
this point, the patient reported to the healthcare team that he had resigned himself
to the fact that he was going to die.
Mr. Green pulled you aside and confided that he planned to kill himself and that it
was a secret that you were not to tell anyone.
Nurses face more and more ethical dilemmas during their practice nowadays,
especially when taking care of the patient at the end of the life stage.
Ethical dilemma identification: The ethical dilemma is if the nursing staff should tell
other health care team members about a patient's suicide attempt without the
patient's consent.
To solve this case and make the best moral decision, the ethical theory, the ethical
principles, and the nurses' code of ethics values statement, the associated literature
relative to this case, are analyzed before making decisions.
The patient, Mr. Green, is a 57-year-old gentleman with aggressive prostate cancer
who is cared for by the nursing team in the oncology department of Cortellucci
Hospital. Mr. Green was diagnosed with prostate cancer seven years ago but
refused medical and surgi.
Critical Thinking Exercise 2Scope of PracticeCynthia Myers is .docxmydrynan
Critical Thinking Exercise 2
Scope of Practice
Cynthia Myers is a registered health information technician (RHIT). She works as a release of information (ROI) specialist at Quinbery General Hospital. Prior to going to college for Health Information Technology, she had completed a year and a half of nursing school. She did well in her classes and really excelled in Pharmacology and Pathophysiology.
At work Cynthia always received excellent performance reviews from her supervisor. She did well and her job, was always willing to help others, and frequently answered disease process questions for the coders.
One day a patient, Bob Snyder and his wife Amy stopped to pick up a copy of his medical records to take to a specialist. The patient asked Cynthia for some assistance in reading the report. Cynthia was thrilled to assist the patient. The patient had bilateral Doppler studies done on his legs to follow-up from a diagnosis of deep vein thrombosis (DVT).Although Cynthia was not very familiar with the report, she told the patient that she did not see anything that looked alarming (to her). As far as she could tell, everything looked normal.
The patient, an avid runner, had been on bed rest for several weeks due to the DVT. He was not to see the specialist until next week, so he and his wife discussed the fact that the woman who gave them the reports interpreted them as normal, and decided it was OK to go running. One mile into the run, the patient developed severe chest pain and shortness of breath. The wife called the ambulance and they transported him to the emergency room at Quinbery General Hospital. Soon after arrival, Bob was pronounced dead. Autopsy showed death due to an embolism.
When the ER physician, Dr. Connie Monday, questioned the wife about what happened, she explained that the employee who provided copies of his records told them that the tests appeared normal. Dr. Monday explained that the person who gave them the records was not properly trained or licensed to determine or interpret the test results and they should have waited for the specialist to review the reports.
Critical Thinking Questions:
1. Communications: Define the problem in your own words.
2. Analysis: Compare and contrast the available solutions within this case study.
3. Problem Solving: Select one of the available solutions and defend it as you chosen solution.
4. Evaluation: Identify the weaknesses of your chosen solution.
5. Synthesis: Suggest ways to improve/strengthen your chosen solution.
6. Reflection: Reflect on your own thought process after completing the assignment.
.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Cases
1. Case 1
Mr B, 50 yrs old consulted his ophthalmologist, Miss M, due to swelling affecting his eyelid.
Miss M examined him and diagnosed a papilloma. She documented no corneal or tear was
observed. The excision surgery was recommended. The consent was obtained; the risks of
bruising, infection, scarring and repeat surgery were warned to Mr B.
Shortly after surgery, Mr B reported to Miss M due to a severe pain on the same eye. The cornea
abrasion was diagnosed by Miss M, another operation was recommended to correct the problem.
2 weeks post operation, the upper eyelid closed, swollen and sever pain. Mr B decided to consult
another surgeon, Dr K, who diagnosed cornea opacity, reduced vision and increased pain. “The
recurrence of your problems could be attributed to the first operation, which I thought the wasn’t
necessary but could be the option , and the operation was not done expertly, the aftercare was not
up to standard” said Dr K.
Mr B made a claim against Miss M for negligence, failed to provide adequate aftercare,
unnecessary operation and he wasn’t given thorough information.
a. Discuss the ethical dilemma in this case.
b. Do you think there were any benefits to the operation?
c. Do you think there was negligence?
d. Is there non maleficence?
2. Case 2.
Mrs G visited his GP, Dr P, for the low backpain. His GP told him the pain could be due to
physical exhaustion of his low back due muscles. Dr P prescribed pain killers and advised
him to do massage to his low back muscles. However, Mrs G asked for injection as her pains
get better on injection than pills. Reluctantly, Dr P injected diclofenac injection on right
buttock and gave her some pills to drink. 3 days later Mrs G started to feel the pain on
injection site followed by the numbness of the right leg and foot. She returned to Dr P who
assured her that the pain will disappear and could be not related to the injection she was
given.
The numbness progress until she could no longer feel her limb. She decided to see a second
opinion from another Dr who told him that was Sciatic nerve injury and she might no longer
be able to walk again with her right limb.
She sue Dr P for negligence claiming that, Dr P was initially reluctant to give her injection
that means he knew the side effects which could happen to her but failed to address them, she
isn’t even sure what was she given.
a) Discuss the ethical dilemma in this case.
b) Do you think there was ethical misconduct?
c) i. List and
ii. Discuss the ethical misconduct if there are any.
3. Case 3.
Mrs T claim to Dr L, the Gynecology & Obstetrician who operated her 18 years ago for
the possible misconduct. She had elective caesarian section. The baby was delivered
normal but after 1 month a scar appeared on the daughter’s right side of the face, owing
to the minor cut wound during operation. Her daughter, 18 years old now, failed to
progress to the beauty contest due to the scar.
Mrs T claim that the operation was unnecessary, she wasn’t informed and given choice of
the procedure and the Dr L didn’t do what other doctor ought to do.
Dr L didn’t remember the case, there are no records of the patient, but the hospital
administration confirmed that, Dr L was the surgeon in charge of the operation.
a. Discuss the ethical dilemma in this case
b. i. Was/were there any misconduct(s)? if Yes, (ii)list them and (iii) discuss why do
you think so.
4. Case 4.
Juma H. Ally and Juma S. Ally were two male patients admitted in the same ward, but scheduled
for different operations. H was supposed to go for brain operation while S was scheduled for
knee operation.
The routine procedure was; the nurse in the ward was supposed to put the labeled plaster on the
patients’ right arm. In the label, the name, the age and the operation to be done was supposed to
be clearly written. Moreover, the patients’ file is supposed to have the same label. These were
done at the ward a day before the operation.
On the operation day, both patients were supposed to be taken to the operation theatre at 7am,
however there were emergencies which delayed the operations till 9am. By 9am, the escorting
nurse (who was supposed to take the patients to the theatre) finished his duties; a new one came
to pick the 2 patients and the other 2.
When the operation started, the brain surgeon was called for emergency and the new one had to
come to take his place. The patients were operated. The surgeons found the normal brain and
knee!!
The Brain patient was operated for the knee while the brain of the knee patient was opened and
operated!! A mistaken identity!! The hospital was sued by both patients.
Do you think there was ethical misconduct in this case? If Yes, List and explain them
If you could be in a medical team, what otherwise could you have done?
5. Case 5.
Miss G had severe anaemia due to excessive menstruation. Dr T decided to transfuse her. The
grouping and cross matching was done and a blood group A+ was sent to the ward for
transfusion.
The transfusion began, Miss G told the nurse she knew she is blood group A-. The nurse
immediately stopped the transfusion , by that time about 5 drops were transfused. She contact the
lab technician who said he will cross check but the transfusion should continue.
The nurse allows the transfusion to continue until after 3 minutes when the lab technician called
her to confirm indeed Miss G is group A-. by that time, about 15 drops were transfused to the
patient.
The nurse then took miss G blood for possible complications (transfusion reaction), all tests
shows negative for reactions. She was then discharged without detrimental effects.
Mrs G later on made the claim to the hospital, claiming the pain, suffering, and emotional stress
among other suffering due to wrong transfusion.
Discuss the ethical dilemma in this case.
Discuss the possible misconduct.
6. Case 6.
Mr R had severe knee pain; he underwent a knee replacement surgery which was initially
successful. 3 months later he complained of difficulty in flexing his knee. His surgeon, Dr P told
him he developed fibrotic changes within the joint. He sent him to physiotherapy for exercises of
the joint, the decision which didn’t please Mr R. He decided to seek second opinion from a
consultant orthopedic surgeon, who diagnosed the problem , wasn’t fibres but he plate from the
knee plate Dr P put on Mr R.
Mr R then claim against Dr P, stating that Dr P placed the wrong plates which made his
condition worse. He incurred a lot of costs, pain, and the pointless manipulation of
physiotherapists for something he thought was wrongly inserted on his knee.
Discuss the ethical dilemma in this case.
Discuss the possible misconduct.
7. Case 7.
Miss Y was seen at the hospital M8 due to labor pains. She was 38 weeks. The nurse in-charge
examined her and diagnose her to have false labor. She was then discharged home and told to
return when the labor pains intensify. After some hours, the abdominal pains worsen; she
decided to go to the other hospital B8. Reading the notice from the previous hospital visit, the
nurse at B8 did not even examined her, she told her it is too early, she have to go home and wait,
otherwise she would stay in the hospital for too long.
Miss Y decided to return home, the pains initially subsided but she started having vaginal
bleeding.
Upon arrival at hospital M8, the doctor diagnosed the rapture uterus and a dead fetus due to a big
baby. The surgery was done, the dead fetus was removed and a uterus was removed due to
severe rapture.
She later sues hospital M8 and B8.
Do you think there were/was misconduct? List them if there are any and discuss.
8. Case 8.
Miss O visited her GP, Dr T, due to flu. Her GP diagnosed tonsillitis. He gave her, among other
medication, penicillin. 3 days later, Miss O returned to her GP with severe rash which involved
the mucous membrane of her eyes, oral cavity and vagina.
Her GP noted the problems and asked her to continue with her medication, “The skin problem
will disappear, the medications are important for your tonsillitis” he said.
Miss O decided to see other practitioner who told her that he suffered from the Steven’s Johns
Syndrome, a fatal reaction due to penicillin. He stopped the penicillin and managed her
accordingly.
Discuss any misconduct in this case.
9. Case 9.
A Motswana lady, Miss W, visited her friends in Liberia before Ebola outbreak. She returned
home in the middle of the outbreak. While arriving at the airport, she was screened and found to
have fever and her passport showed that she visited Ebola epidemic areas. The health team at the
airport decided to keep her on guarantee for the next 21 days.
She was later found to have no infections and released.
She claimed to her authority that the action were against her rights and grossly misconduct.
Discuss the medical-ethical dilemma in this case.
Mention and discuss the rights violated in this case.
10. Case 10.
While pregnant, Miss R, visited her GP who did the ultra sound at 12 weeks. The scan revealed
the well progressive pregnant. The GP advised her to do another scan at 7 months. At 8 months
Miss R did another scan which revealed a normal pregnancy. She delivered at 9 months to the
abnormal baby having a phocomelia. After some consultation with other experts, she was
informed that the condition could be (not necessarily) due to some medication given during
pregnant, the condition could be diagnosed during pregnancy by scan, if at all it was done
properly.
Miss R claim that, her GP gave her some medications which caused the problem and he failed to
diagnose the condition twice while pregnant, if the condition could be diagnosed earlier she
could opt for medical abortion.
Discuss (if there is/are) misconduct(s) in this case.
11. Case 11.
Miss R delivered the low for age baby at the hospital. Despite being low for age, the baby was
doing fine initially. However, she was told to stay in hospital for some weeks for observation of
her baby at neonatal ward. No more information was given.
In the neonatal ward, Miss R noted the nurse touching the navel of her baby; she became
suspicious that she could be contaminating her baby simply because she didn’t see her changing
the gloves or washing the hands.
The baby was doing fine, until after 7 days when he developed the yellow discoloration of the
skin, eyes and mucous membrane. Also there was fever, rigors, unable to breastfeed and
lethargy looking baby.
The Dr in-charge diagnosed septicemia, and he said could be due to the infections of the navel,
possibly contamination. The baby later developed some complications which made her to stay
more in hospital and costly treatment.
She later claimed to the hospital that the nurse contaminated her baby.
Discuss the misconduct(s) in this case.
12. Case 12.
HIV discordant couple ( a woman was HIV+) consulted their GP for advice; they wanted to have
the child. The Dr assured them that, simply because they are on medication the chance of getting
the infected child is minimal if the mother will take the medication as advised.
No more information was given/recorded.
During one of the visit, the pregnant lady asked her doctor about the information on the leaflet of
her ARVs, that the safety of the medication in pregnancy is not proven. However the doctor
assured her that there will be no problem.
The lady gave birth to the congenitally malformed child and claim to the Dr for misconduct(s)
during the pregnancy which will torture her psychologically, financially and socially.
Discuss the misconduct(s) in this case.
13. Case 13.
Miss W gave birth to the baby having neural tube defects. When inquiring about the condition,
she was informed probably was due to deficiency of folic acid during pregnancy, something
mandatorily given to all pregnant women on their first visit to the clinic.
She doesn’t remember to be told about the folic acid. When she cross checked the clinic card,
nothing was written that she was given the medication. And nothing was documented in ultra
sound she did at 28 weeks.
She claims that the condition of her child was the fault of the hospital.
Discuss the misconduct(s) in this case.
14. Case 14.
Ms X was seen by Dr T, she mentioned she missed her period for 2 months, she suspected she
was pregnant and don’t want the baby (in the country where abortion is legalized). A pregnancy
test (urine) was done by Dr T which proved positive, but the ultra sound didn’t show gestational
sac.
Dr T gave her cytotec pills to induce abortion. 2 days later, Ms X came back to Dr T complained
of bleeding and severe abdominal pain, the ultra sound shows the rapture of the right fallopian
tube. The surgery was done; the right fallopian tube was removed.
Some years later, Ms X brought a claim to Dr T and the clinic that despite she wanted abortion
which was her rights of choice, the Dr done some misconduct that made her right tube to be
removed and now she no longer conceives because the left tube was long blocked.
Discuss the misconduct(s) of Dr T if there are/is any.
15. Case 15.
Mr K had progressive loss of vision for years. He finally saw Dr P, who diagnosed the glaucoma,
the eye disease due to raise the pressure inside the eye which might lead into blindness, the
disease can be corrected by surgery.
Dr P gave him some medication. 3 months later, the condition worsens, Mr K returned to Dr P,
who gave him another treatment.
After 6 months of no recovery, Mr K decided to see Dr M who is eye specialist. After
examination, Dr M discovered the glaucoma and the condition could no longer be managed
because he came late to see him. “If you could be here 3-6 months ago, this condition could be
100% cured”, said Dr M.
3 months later Mr K became blind.
Mr K claim to Dr P for misconducts when managing him.
Discuss the misconduct(s) of Dr P if there are/is any.
16. Case 16.
Mr P had severe abdominal pain. Dr Z, diagnosed the acute appendicitis. The surgery was done
and the drain (a small tube inserted into the abdomen to control/reveal the bleeding if there is any
was inserted). He was discharged after 3 days, Dr Z removed the catheter before Mr P was
discharge from the hospital.
3 days later, Mr P was returned to the hospital with distended painful abdomen and he was pale.
The ultra sound revealed intra abdominal bleeding/fluid. The explorative surgery was done to
reveal the problem. He was bleeding and had pus all over the organs, he died 2 days later.
The cousin to Mr P consult the second opinion, they were told that in a standard way, the drain
was supposed to remain for 7 days, and if that procedure would have been followed, Dr Z would
discover the bleeding earlier and necessary measures could have been taken.
Discuss the misconduct(s) of Dr Z if there are/is any.
17. Case 17.
Mrs. B was diabetic, hypertensive and had kidney failure. She was comatose at the referral
hospital. Before her condition worsens, she asked her family not to suffer due to her; they
should let her die in peace in case she became very sick.
When she was comatose, assisted by cardio respiratory machines for 1 month, her husband
reluctantly asked the doctor to let her wife die in peace; however this is disputed by one of his
daughter. This is despite the efforts of the medical team to revive Mrs. B condition.
a. Discuss the medical-ethical dilemma.
b. What would you suggest the Dr should do? And why?