Role of Genomics Educated Nurses

Role of Genomics Educated Nurses GENETICS ROLE IN HEALTH CARE OF PATIENTS 1 Evidence Based Practice Paper on Genetics Role in Health Care of Patients Minimol Shebeen American Sentinel University Evidence Based Practice Paper on Genetics Role in Health Care of Patients Evidence-based practice (EBP) is the incorporation of clinical skill, patient advantages and the best research evidence into the decision-making process for patient care. Clinical expertness relates to the clinician’s gathered knowledge, education and clinical abilities. The patient brings to the encounter his or her own personal likings and unique concerns, hopes and values. The finest research verification is normally established in clinically significant research that has been organized using sound methodology. (Duke University Medical Center Library, 2013). The majority of diseases jeopardizes, health situation and the remedies used to treat those conditions has a genetic element impacted by lifestyle, environmental and other factors, and therefore affecting the whole nursing profession. Nurses have intimate knowledge of the patient’s, family’s, about community’s perspectives and an understanding of biological supports. Nurses also have experience with genomic technologies and information along with skills in communication and building coalitions and most importantly, the public’s trust. Nurses are well positioned to incorporate genetic and genomic information across all aspects of the United States health care system. Nurses, the most trusted health professionals, make unique contributions to the field of human genetics and genomics and complement the work of other health care providers to improve the health of the public (Calzone et al., 2010). This paper looks into the role of genomics educated nurses in saving lives and improving health care quality. Genetic Engineering According to The Columbia Electronic Encyclopedia (2013), genetic engineering is the use of different methods to engineer the genetic material of cells to change hereditary features to produce biological products. Various techniques are used, including Use of hybrids of quickly proliferating cancer cells and cells that make a needed antibody to make monoclonal antibodies Polymerase chain reaction in which complete copies of Deoxyribonucleic acid (DNA) fractions are made and used in DNA fingerprinting. Gene splicing, in which DNA of a wanted gene is inserted into a DNA of a bacterium which then reproduces itself producing more of the wanted gene. Genetically engineered outputs include bacteria intended to break down industrial waste products and oil slicks, drugs like human insulin, human and bovine growth hormones and interferon. It may also degrade plants that are resistant to insects, diseases and herbicides, that yield fruit or vegetables with desired qualities, or produce toxins that act as pesticides. Genetic engineering methods have also been used in the direct gene conversion of livestock and laboratory animals (The Columbia Electronic Encyclopedia, 2013). Legal and Ethical Issues According to Lea (2008), genetics have developed to include the effect of a person’s entire genome, environmental elements and their joint effects on health. This growth is creating new, gene-based technologies for the preview, diagnosis, prevention and treatment of both uncommon and common diseases, such as cancer, heart disease, diabetes and stroke. New genomic breakthroughs and their implementations bring great expectation for a more personalized appeal to treat disease. While these new indications raise expectations for disease prevention and treatment, they also bring hard ethical issues to patients and healthcare providers in a similar way. Some of the ethical challenges for nurses are Privacy and Confidentiality Who shall have reach to genetic data? Who owns and commands it? How can families settle differences when some members want to be tested for a genetic disturbance, and others do not? Discrimination Should managements be able to need job appliers to take genetic tests as a requirement of employment? Unbiased Access to Genomic Technologies Resource-poor countries, the uninsured, rural and inner-city communities – how might genomic science and treatments be made available to those with fewer reserves? Rare genetic conditions – who will invest the progress of treatments for genetic disorders that affect a comparatively small number of people? Influence of Genetic Data How does a person’s genetic data influence that individual and society’s feeling of that individual? How do genes and genomic facts affect fellows of minority populations? According to National Human Genome Research Institute (2007), certain ethical, legal and social issues research areas identified as the main challenges for the future of genomic research: Intellectual property issues surrounding the approach to and use of genetic knowledge Ethical, legal and social factors that impact the interpretation of genetic data to improved health Problems surrounding the manners of genetic research Issues surrounding the use of genetic knowledge and technologies in non-health care backgrounds The impact of genomics on notions of race, kinship, ethnicity and individual and group identity The associations for both individuals and society of unveiling genomic inputs to human features and conducts How different individuals, cultures and religious practices view the ethical boundaries for the uses of genomics Mandatory Screening Newborn screening is a growing use of genetic examination. A technology called Tandem Mass Spectrometry is now being used by many state newborn screening programs, permitting screening for more than 24 distinctive genetic disorders using one easy test. This widened newborn screening raises new issues about well-informed decision making. As illustrated by the American Academy of Pediatrics, genetic testing varies from other types of medical testing in that it provides information about the family. For example, a diagnosis of Phenylketonuria (PKU) made in an infant through newborn screening means that the infant’s parents are carriers, and that they have a 25 percent chance with each future pregnancy for having another child with PKU. Each of the parents’ siblings has a 50 percent chance to be transporters. Thus, the screening results may have related social, psychological and financial risks. Parents who are carriers may have psychological risks which may comprise parent al responsibility. A child diagnosed with a genetic condition may face descended identity and risk insurance and employment unequal treatment. At present, most states have mandatory newborn screening agendas that require all infants to be screened unless the parents deny. This is called informed dissent, with least information supplied to parents. An informed consent process, on the other hand, would include talk with the parents about the risks, restrictions and benefits of newborn screening before consenting to the testing. Having an informed consent procedure for newborn screening has the attitude for faster and efficient responses to positive outcomes. The American Academy of Pediatrics has recommended that pediatric providers give parents the needed data and counseling regarding the risks, benefits, and limitations of newborn screening, and that they cooperate with genetics professionals and prenatal care providers in providing this difficult information to the parents. There a re currently two states that require informed consent for newborn screening, Maryland and Wyoming. Thirteen other states need that parents are well-informed about the newborn screening ahead the testing is done on their infant. All but one state, South Dakota, permit parental rejection of newborn screening for religious or personal reasons (Lea, 2008). Healthcare Providers Role in Gene Therapy The nursing profession is a crucial contributor of the finest health care services and is key to ending the gap between research breakthroughs that are effective for health care and their affluent adoption to optimize health. Every year, over 106,000 people in the United States will die from adverse effects from medicaments ordered and dispensed in correct dosages, and over two million will bear grave but not life-threatening toxicities. Among individuals 65 years of age or older, 17.3 percent of adverse drug event related emergency department visits were connected with warfarin, the majority of, which were dose-related with 44.2 percent needing hospitalization. Individual genetic markers are among the causes that add to the decision of warfarin dose conditions. A strong nursing element, can decrease the extent of life-threatening hemorrhage or sub-therapeutic dosing that can result in thrombosis as an outcome of individual responses regulated by genetic structure. Despite an expandi ng body of evidence with the addition of genetics and genomics to health or illness, the proof specific to results of genetically competent nursing practice and the effect on the public’s health is very insufficient. However, individual stories point to the possibility for changing health care by the genomically competent nurse (Calzone et al., 2010). A nurse who is informed about genetics and trained at acquiring and reviewing risk in a family history have the possibility to help people avert adult-onset disorders and resulting morbidity and mortality. More than 180,000 new cases of breast cancer are identified yearly, of which approximately 5 to 10 percent will have an inherited vulnerability to the disease. A nurse case manager took a brief family pedigree of a woman to recognize any information persistent with an inherited vulnerability to cancer. The nurse recognized a paternal family history of early-onset breast cancer and her ethnic legacy, Ashkenazi Jewish, together induced her risk of having a mutation in a breast cancer vulnerability gene. The nurse directed this woman to a cancer genetics professional. The proof points to not only a reduction in morbidity and possible mortality, but also to a health care saving of hundreds of dollars per life year as an outcome of the nurse’s activity (Calzone et al., 2010). Annually, about 180,000 to 250,000 people in the United States will bear a sudden cardiac death. The nurses informed in genetics can aid people prevent sudden cardiac death. A cardiac echocardiogram was carried out by a cardiovascular advanced practice nurse (APN) on a patient who told the story about many family members who had died unexpectedly from a heart attack. Attracted, the APN obtained a family history and shared it with one of the cardiologists. Over a few years, the APN collected a broad many generation family history that comprised members situated in many states and many countries and found that many had died in their teens and early adult years. The family took part in a research study and final the gene and disease specific mutations were recognized. The women later arranged her appointment with a cardiologist. Over an eight-year period, she had an implantable cardioverter defibrillator placed, which cardioverted her on two different instances, proceeded by two ablatio n surgeries for atrial fibrillation. Later, the woman was pregnant with her first child. She described that her pregnancy was possible because of the APN’s genetic proficiency and close supervision, education of other health care professionals participating in the woman’s prenatal care, and her direction and support throughout the pregnancy. In this family, the APN had prevented the premature death of many at risk family members by attending to and also inquiring into a family history over ten years (Calzone et al., 2010). In preconception and prenatal backgrounds, nurses have a chance to help families ready for a child with a genetic situation. Congenital malformations are the main cause of infant death in the United States. A 48-year-old woman recollected her episodes with the birth and later death of her two children with distinctive chromosome disorders. She differed her fierce suffer with her first baby to her dramatically better encounter 10 years later with her second baby. When the woman was 30 years old, she got a call at work from the obstetrician’s office that her genetic screen was abnormal. A follow-up amniocentesis showed that her growing baby had Edwards syndrome. The woman selected to carry on her pregnancy. When her daughter was born, the mother felt very little assistance from the physicians and nurses. She described them as a task directed and very clinical. When she was released home with her baby the mother felt left behind by the health care system; her only contact with he alth care professionals being her baby’s pediatrician, who had never cared for a child with this disease during his 20 years of service. After around ten years, the woman got to be pregnant with her child. Because of her age and history of having a previous child with a chromosome disorder, as a reassurance, the woman selected to have an amniocentesis. However, the results showed she was pregnant with a male fetus who had Patau syndrome. In comparison to her preceding experience, she was directed to a pediatric hospice service. The nurses’ and physicians’ skill about Patau syndrome and the expected clinical course was reassured to the woman. The nurse made sure all labor and delivery, and postnatal staff were informed about Patau syndrome and aware of the expected birth as well as the plan for relief attention. The nurse kept up touch with the woman during the pregnancy and gave hospice care during the woman’s son’s 12-week life span (Calzone et al ., 2010). Conclusion Evidence based practice in nursing is based on the idea that medical practices need to be adapted and amended based on the continuing cycle of evidence, theory and research. As the research continues new issues were found and theories are developed forcing changes in practice. Genetic engineering involves manipulation of the organisms genome utilizing biotechnology. Nurses work close to the patient more than any other healthcare professional. Due to the same reason nurses could easily observe the changes in patients. Evidences show nurses who have the proper knowledge in genetics could save many lives and improve a patients quality of life. Therefore educating and training nurses and keeping them up-to-date with the latest technological advances will be an addition to the overall healthcare. Reference Calzone, K. A., Cashion, A., Feetham, S., Jenkins, J., Prows, C. A., Williams, J. K., Wung, S. F. (2010). Nurses transforming health care using genetics and genomics. Nursing Outlook, 58(1), doi: 10.1016/j.outlook.2009.05.001 Duke University Medical Center Library. (2013, December 06). What is evidence-based practice (ebp)? . Retrieved from http://guides.mclibrary.duke.edu/content.php?pid=431451sid=3529499 Lea, D. H. (2008). Genetic and genomic healthcare: Ethical issues of importance to nurses. The Online Journal of Issues in Nursing, 13(1) National Human Genome Research Institute. (2007, November). ELSI research program. Retrieved from www.genome.gov/10001618 The Columbia Electronic Encyclopedia. (2013). Genetic engineering. Retrieved from http://encyclopedia2.thefreedictionary.com/Genetic manipulation

Abortion Should Not be Banned :: Abortion Pro Choice Essays

The main problem in the world is inevitable abortion. Because it is about morality; which people tend pay more attention. Nowadays, Abortion is a controversial problem as people think of appropriateness. However, Abortion is necessary in many cases. Three main reasons why abortion should be banned are condition that women are not pregnancy, health problem in mother, and social problem. First, the pregnancy without readiness because the teenagers has sexual relation â€Å"premature† because nowadays it has communication is easy and comfortable. It make teenagers can getting to know it easier and sometime the women it may be deceptive in a way that is not good, for example indecent, fraudulent. Especially the pregnancy has not ready is in school because the women may be problem in social is drop out of school (Growing up global, 2005 p.540) Because of poor academic and the lack opportunities in economic not only economic but also is good occupations and social is good the children of mother have not finish it becomes problem side working, such as cheap labor in the factory. Perhaps someone is pregnant in school have an abortion in the school it help open opportunity for continue to study for the future. Sometime, husband and wife the protection of sexual relation has failed from process condom for example using low quality materials. The causes of the family i t reason why want to abortion because not ready take care a baby is born. Secondly, The health of the mother, body of physical disorders of the body. The major reason that abortion should not be banned is for preventing transmission of Human Immunodeficiency Virus (HIV) from mother to infant during pregnancy â€Å"reduce maternal morbidity and mortality† (Rudolph Gurtovnik, 2008, p.28) it is the big problem that the government has to solve and spent a lot of budget to treat all of these people. Some women feel that they have not the economic resources to take care a HIV child. A HIV status may also the cause women to reject their pregnancy. Some women need to restrict their incomes for accessing on a meditation and treatment to family members’ HIV infection. On the other hands, a pregnancy woman also has a negative impact to her health HIV women access abortion because they intentionally choose not to have a child and also fear that their pregnancy would lead to both mother and child poor health and death. Finally, the main clause a big problem of social problem is the accident situation has effect when the women are raped.

Analysis of poem “Muliebrity” by Sujata Bhatt Essay

The poem muliebrity by Sujata Bhatt, talks about the power women possess and the character of women, who take pride in what they do, even if it is just picking cow-dung. The poet speaks of a girl, who is a representation of village women, who does the tedious job of picking cow-dung outside a temple and the girl is described in a very reverential manner. The title of the poem muliebrity, suggests womanhood. The connotation of the title, status and power of a woman, is reflected in the poem where the author uses the words greatness and power. The poet talks about her imperative childhood experiences through her poems, using an optimistic tone, to make it more affective. With a delightful tone, she describes the scenery at the village. There is use of enjambment in the poem, to stress on how long ago the poet saw the girl and it could also suggest a feeling of nostalgia. A very simple tone and language is used in the poem, to indicate the simplicity of the situation. The poet says that she has thought so much about the girl, suggesting that the poet respects the girl and is in awe of the way the girl holds her head high, despite the fact that she does a menial job of picking dung. The poet ponders on why the girl does something that isnt usually expected to be done by her and stresses on the dignity of labour showing how, even though it is an undermining task, she does it happily. She is impressed by the girls commitment and dedication to her work. A very positive approach is shown towards the work done, as expectations do not stop the girl from doing what she wants to do. The poet, very intricately describes the feminine movements and attitude of the girl toward her job. she talks about the way she moved her hands and waist, indicating the presence of womanhood in the girl, and even though her job is to scoop dung, which is considered as a very demeaning job, she has retained the femininity in her and still has pride in herself. Even further in the poem, the author depicts the independence of the girl, as she says power glistening through her cheekbones. The poet also describes the stench of the atmosphere in which the girl has to work, as she says smell of cow-dung and smell of monkey-breath. On the contrary, the smell of freshly washed clothes and of canna lilies is also  mentioned, which tells us that though the girls job is not very dignified, the poet approaches the girl very positively. The girl picks up dung outside a temple, which shows that she is serving the society. The poet interprets this job as one which is very respectful. She uses visual imagery, as she describes the surroundings of the girl and the repulsive smells in so much detail, that the audience would be able to imagine the situation. The smells besiege the poet separately and simultaneously, which tells us that though all these smells are present together, she describes them individually so that it has a deeper impact on the readers. The poet says that she doesnt want to use the girl as a metaphor, and as a role model for every other woman, but she doesnt want to forget the girl, who retained the womanhood in her, irrespective of her job. The poet explores all the feminine qualities of a woman through this poem, elegance, pride, dignity, independence and the way a woman presents herself to the world, having a strong and powerful personality. The poet indirectly conveys to her audience how an ideal woman should be, possessing all the above qualities, and even though the poet mentions that she doesnt want to use the girl as a metaphor, she subtly expresses that every woman should exhibit such traits. Even as the girl picks up cow dung, she feels good about herself, as she is doing this job for her living, and she takes pride in it, which is what the poet tries to tell the audience. The image of the girl is portrayed very well, and the author uses the girl effectively to explore womanhood. http://en.wikipedia.org/wiki/Muliebrity

Sport Psychology - 1034 Words

tExercise is an accessible method of fulfilling a person s physical goals which they have for their own body. Humans are capable of engaging in a variety of exercises including running, playing a game of volleyball, or even surfing. In spite of the many physical accomplishments which humans can gain from physical exercise, people are also capable of encountering many psychological benefits from doing so. Studies have shown that exercising release certain chemicals in our brain that results in a good feeling. For instance, a late The beauty behind physical exercise is not only due to physical benefits which humans receive due to it, but also from the positive psychological energy given to humans that helps motivate us to continue†¦show more content†¦Another technique which individuals can use is autogenic training which centers a human to produce warmth and heaviness, that can eventually leads to a state of relaxation. Another technique that can be applied to one s life in order to help one to regulate arousal during performance is called multimodal anxiety reduction packages. A well known form of this anxiety reducing technique is called stress management training. SMT consists of applying relaxation and cognitive components to one s form of coping responses to emotional arousal that may arise within. Another example of a multidomal anxiety reduction that may fortify one s way of coping with stress is through stress inoculation training. This particular training involves exposing a human to stressful components, including mental images, and self-statements, that fortifies a human s resistance to stress. Therefore, as mentioned before, arousal regulation is a particular coping mechanism which athletes can greatly benefit them in order to excel in their physical and mental performance when playing a sport. 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