Discuss the relationship between diabetes and heart disease.
3) In July, 2019 the U.S. Government announced a settlement of $700 million for a data breach by Equifax. Please discuss 3 key controls from our reading and discussions that Equifax did not handle appropriately. In your discussion, indicate what the control is, how it is supposed to work, and your opinions on why Equifax opened themselves up for such a big loss by not appropriately executing the controls. https://www.governing.com/topics/finance/tns-equifax-data-breach-settlement.html
History is about telling stories. There is arguably no greater medium to tell stories in today’s society and culture than movies. Films have the ability to not only tell us stories about their intended subjects, but provide details about contemporary issues influencing screenwriters and directors. For example, Westerns made during the Cold War have as much to tell us about what Americans were thinking about and debating in the 1950s and 1960s as they do about the actual history of the American West in the 1800s. For this Assignment I would like you to view the films pertaining to World War Two and submit a response that addresses the following: 1) Based upon your knowledge of World War Two, is this film accurate regarding its portrayal of the conflict? Why or why not? 2) Why do you believe we are still so interested in the history and stories of World War Two? How do you believe the time period this film was made influenced changing perceptions of World War Two over time? (For example, what are some of the themes displayed in a 1990s film regarding WWII that perhaps have more to do with what was going on in America in the 1990s than the 1940s?) Possible Movie Choices: The Great Escape (1963) The Dirty Dozen (1967) Patton (1970) Saving Private Ryan (1998) The Thin Red Line (1998) Flags of Our Fathers (2006)
In June, 2018, McDonald’s announced that self-service ordering kiosks would be in all 14,000 of its stores by the end of 2020. discuss in terms of what it means to the revenue cycle at McDonald’s and 3 impacts of installing this type of technology. Other articles can be used besides this one, if desired. https://www.cnbc.com/2018/06/04/mcdonalds-to-add-self-order-kiosks-to-1000-stores-each-quarter.html
Write a research paper analyzing and evaluating the legal systems of the US, Israel, and a Middle East country .
Sickle cell disease Sickle cell disease is a group of inherited genetic disorders that affect red blood cells. It is as result of mutations on the hemoglobin molecule. Usually, the red blood cells are discoid shaped. However, in sickle cell disease the shape of the red blood cells is distorted to form a crescent-like shape referred to as sickled. The affected red blood cells are usually prone to hemolysis, which leads to anemia. Sickled shaped red blood cells also tend to stick on the walls of the blood vessels, causing a blockage. Blockage often results in tissue damage and pain. Other associated symptoms include hypertension, organ damage, neurological complications, recurring infections, arthritis, chest pains, and coughs. Sickle cell disease exists in various forms. The most common variant is the HbSS, which results from the inheritance of sickle cell gene (“S”) from either parent. This form is typically the most severe form of the disease. It usually results in chronic anemia. (Rees, Williams, & Gladwin, 2010). Drugs used in the treatment and management of sickle cell disease and associated symptoms Sickle cell disease is a condition that worsens with age. Treatment options such as disease modifiers and supportive agents can prevent complications and prolong the lives of those living with the disease. Treatment for sickle cell disease and its associated symptoms include: 1. Hydroxyurea. It works by inducing fetal protein hemoglobin, reduces red blood cells adhesion and decreases the number of red blood cells. 2. Opioid analgesics to ease pain such as aspirin, methadone, and morphine sulfate, acetaminophen, and fentanyl. 3. Nonsteroidal anti-inflammatory drugs such as ibuprofen, acetaminophen, and aspirin. 4. Antibiotics such as amoxicillin, azithromycin, cefuroxime, and penicillin VK to treat associated infections. 5. Vaccines such as a meningococcal vaccine, influenza vaccines, and other recommended children and adults scheduled vaccines. 6. Endothelin -1 receptor antagonists such as bosentan and ambrisentan, which treat hypertension. 7. Tricyclic antidepressants such as amitriptyline. 8. Phosphodiesterase inhibitors, such as sildenafil or tadalafil. 9. Vitamins such as folic acid for neuronal development. 10. L-glutamine powder called Endari that is given orally to prevent sickle cell crisis in adults and children above the age of five. 11. Anti-nausea such as promethazine. (Yawn et al. 2014) Impact of genetics on the efficacy of the drugs used in sickle cell disease Although sickle cell is a monogenetic disease, it expresses a variety of phenotypic variation. Response to drugs given to manage sickle cell disease varies in patients depending on the genetic polymorphism. For instance, some patients exhibit intolerance or no response to hydroxyurea. This has been attributed to the genetic variation in Hbf induction. Researchers have found specific genes markers such as KLF 10, ARG 1, ARG 2, and CAR that can be used to predict the response of patients to hydroxyurea. The response to opioids is also variable in different patients. Occasionally nurses tend to associate this variability to nonadherence to treatment. However, recent research shows that the perception of pain and response to opioids varies widely as a result of genetic polymorphism in the COMT, ABCB 1, and OPRM 1 genes. (Husain, Hartman, & Desai, 2017). Measures to reduce side effects associated with drugs used in managing sickle cell disease. Most patients using hydroxyurea rarely exhibit any side effects. However, a few may complain of nausea, irritation, and headache. Management of these side effects can be done using, such as antiemetic and painkillers, which ease nausea and headache, respectively. Side effects associated with chronic use of opioids and other analgesics can be managed by alternating one opioid with another, changing the route of administration, and reducing the dosage given. Sickle cell disease is a chronic condition that needs to be managed keenly throughout a patient’s life. Nurses have a role in providing quality healthcare to these patients to improve quality and prolong their lives. Healthcare givers should reiterate on adherence to improve pharmacotherapy intervention response. References Husain, M., Hartman, A. D., & Desai, P. (2017). Pharmacogenomics of sickle cell disease: steps toward personalized medicine. Pharmacogenomics and personalized medicine, 10, 261–265. doi:10.2147/PGPM.S123427 Rees, D. C., Williams, T. N., & Gladwin, M. T. (2010). Sickle-cell disease. The Lancet, 376(9757), 2018-2031. Yawn, B. P., Buchanan, G. R., Afenyi-Annan, A. N., Ballas, S. K., Hassell, K. L., James, A. H., … & Tanabe, P. J. (2014). Management of sickle cell disease: summary of the 2014 evidence-based report by expert panel members. Jama, 312(10), 1033-1048.
Thalassemia is an inherited autosomal recessive blood disorder that is passed to children via mutated hemoglobin genes. This is most common in people who are African-American, of either Mediterranean and/or Southeast Asian ancestry. (Arcangelo, Peterson, Wilbur, & Reinhold, 2017) This causes clinically severe anemia due to an in an imbalance of either the a- or b- globin chains. In simple terms, there are fewer red blood cells in a person’s body therefore there is less hemoglobin which restricts the amount of oxygen can be carried throughout your body causing anemia leaving one very fatigued. (Taher, Weatherall, & Cappellini, 2018) There are four genes that are responsible for the production of a-globin chains and mutations of these can result in a-thalassemia and depending on the number of mutations a person will either be a silent carrier, have mild or even severe anemia. (Arcangelo et al., 2017) Any patient with even a more mild form of Thalassaemia will need to be monitored closely for iron deficiency. (ARC) Chronic transfusion is considered in patients when the hemoglobin concentration is consistently below 6–7 g/dL. (Chonat & Quinn, 2017) Unfortunately with chronic blood transfusions comes the high potential of iron overload to a person’s vital organs greatly increasing the chances of that person to fall into organ failure. (Taher et al., 2018) In order to avoid iron overload iron chelation therapy should be considered which is accomplished with deferoxamine, deferasirox, and deferiprone. First course of action should be determining a serum ferritin level baseline to check for effectiveness of the iron chelation therapy. First stage is to use Deferoxamine subcutaneous infused for up to 24 hours. This is followed up with Deferiprone 3 times per day. Deferasirox can be substituted for subcutaneous Deferoxamine used as a first-choice treatment as it comes in an oral liquid suspension. (Chonat & Quinn, 2017) Children who have Thalassaemia with require regular blood transfusions during their first year of life in order to achieve normal development. When this happens iron chelation therapy is not done in the normal time frame which would be within one year of transfusion. In the case of infants, the therapy is delayed beyond one year due to the toxicity of the iron chelation. (Carson & Martin, 2014) Much care and thought my be utilized to allow these infants to develop and grow into healthy adolescence and achieve puberty without unnecessary delay. References Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (2017). Pharmacotherapeutics for Advanced Practice (4th ed.). Philadelphia, PA: Wolters Kluwer. Carson, S. M., & Martin, M. B. (2014). Effective iron chelation practice for patients with ß-thalassemia major. Clinical Journal of Oncology Nursing, 18(1), 102-111. http://dx.doi.org/10.1188/14.CJON Chonat, S., & Quinn, C. T. (2017). Current Standards of Care and Long Term Outcomes for Thalassemia and Sickle Cell Disease. Advances in experimental medicine and biology, 1013, 59-87. http://dx.doi.org/10.1007/978-1-4939-7299-9_3 Taher, A. T., Weatherall, D. J., & Cappellini, M. D. (2018). Thalassaemia. The Lancet, 391(10116), 155-167. http://dx.doi.org/10.1016/S0140-6736(17)31822-6
Choose 2 different practice settings: one that represents where you currently work or have worked, and another that you are interested in exploring. Examine the similarities and differences in conditions of coverage and participation related to your 2 chosen factors. Consider the following: Staffing requirements Release of patient records Patient rights Administrative structure Another aspect relative to the specific care environment
Discuss 3 risks and 3 benefits of cloud-based computing especially as it relates to the expenditure cycle of an organization.
Write a concise paper on various accounting principles and how to go about using them, responding to the research questions my teacher gave, which are fairly easy.