Monday, January 27, 2020

Systemic Lupus Erythematosus Autoimmune Disorder

Systemic Lupus Erythematosus Autoimmune Disorder AUTOIMMUNE DISORDERS The immune system is an important system within the human body that defends against disease and internal malfunction. When there is an invader or a pathogen, the bodys immune system responds accordingly, usually destroying the pathogen before it can infect the body and cause illness. The immune system also helps identify malfunctioning cells and eliminates them before faulty DNA is replicated. Autoimmune disorders occur when the immune system of a patient no longer identifies foreign versus self correctly. The immune system of a patient with an autoimmune disorder will attack the bodys cells or tissues causing damage or death. (Lettre Rioux, 2008). Autoimmune disorders can be genetically predisposed, but just because a patient is predisposed to a particular disorder does not mean they will necessarily experience it. Often times, autoimmune disorders occur through a combination of genetic predispositions and environmental factors. This means a patient may have a genetic predisposition for systemic lupus erythematosus but the disorder is triggered by an invading virus the patient encounters and only thereafter do they suffer from the symptoms of SLE. There are now 68 genetic precursors that are linked to the development of autoimmune disorders, while in the past only about 15 had been identified. Symptoms of autoimmune diseases vary depending on what part of the body the immune system is attacking (Understanding Autoimmune Diseases, 2016) (Lettre Rioux, 2008). Within the immune system there are several types of cells. B-cells and T-cells play key roles within the immune system and in autoimmune diseases. There are two types of T-cells, CD4 T-helper cells that identify an invader and make the antibody creating B-cells aware and CD8 cytotoxic T-cells which will destroy a previously encountered threat without stimulating the creation of antibodies by B-cells. CD4 T-cells are also known as regulatory T-cells (Treg cells). These Tregs play a role in preventing autoimmunity by maintaining the ability to identify self. When these cells no longer identify self properly or at all, an autoimmune disease occurs. When T-helper cells do not identify self-versus-foreign properly they stimulate B-cells to create antibodies to destroy the bodys tissues or cells, called autoantibodies, or the cytotoxic T-cells will destroy the tissue or cells of oneself. (Venes et al., 2005, pp. 132, 135, 203, 204) (Corthay, 2009) (Hampe, 2012). SLE or Systemic Lupus Erythematosus is an autoimmune disease most commonly characterized by joint pain (arthralgia) and swelling (edema). SLE can also cause fatigue, mouth sores, sensitivity to sunlight, and butterfly rash across the cheeks and nose of the face, and hair loss. Other symptoms depend on where the body is being attacked by the immune system. For instance, if the immune system of a patient with SLE is attacking the heart of the patient an additional symptom of arrhythmia may be experienced. (Systemic Lupus Erythematosus, 2016). Diagnosis of SLE can be difficult as it can be associated with varying symptoms. A test known as antinuclear antibody test (ANA) is used to help diagnose SLE. An antinuclear antibody is an antibody created by the patients immune system to attack the bodys tissues and cells. Some ANA tests are enzyme-linked immunosorbent assay (ELISA) and indirect florescent antibody (IFA). These tests examine how many antinuclear antibodies are present in a patients blood. ANA tests are used when the autoimmune disease may be affecting more than one area of the body; this is called a systemic autoimmune disease. Because SLE is systemic, an ANA test helps confirm that SLE is the diagnosis as opposed to rheumatoid arthritis. However, having a positive ANA test does not mean that a patient has SLE. SLE is often misdiagnosed as rheumatoid arthritis because they share common symptoms such as edema and arthralgia this is why doctors often use an assortment of other tests to diagnose SLE, along with a physi cal exam as four of the eleven common symptoms of SLE must be present before a patient can be diagnosed. Some of those common symptoms were listed above: butterfly rash across the face, joint pain, sensitivity to sunlight, hair loss, fatigue, and edema. (Antinuclear Antibody, 2017)(Starkebaum, 2016)(Bocco, 2017). Systemic Lupus Erythematosus can be treated but not cured. Because it is an autoimmune disease, SLE is treated with immunosuppressants. Hydroxychloroquine (HCQ) is an immunosuppressant that slows down the immune system and its attack on the bodys tissues and cells. HCQ was originally used in the treatment of malaria and is known as a disease-modifying anti-rheumatic drug (DMARD). It is recommended that patients diagnosed with SLE immediately start a HCQ regiment as this drug help prevent further damage from the disease process. HCQ is usually used in chorus with other pain relief drugs because HCQ itself does not provide immediate pain relief. NSAIDS (nonsteroidal anti-inflammatory drugs) are often used in joint pain management for patients with SLE. Over time, HCQ will help relieve joint pain in SLE sufferers as well as help stop further damage to any other affected organs and joints. Corticosteroids are often also prescribed to those with SLE as joint pain is a prominent symptom of SLE. Corticosteroids mimic naturally produced strong anti-inflammatory substances within the body. However, treatments come with risk factors. In rare cases, HQC can cause retinopathy; retinopathy is when vision is altered or complete blindness occurs. Likewise, long term use of corticosteroids has adverse effects including: osteoporosis, hyperglycemia (high blood sugar), and cataracts. Dosage of corticosteroids are adjusted for long term use in patients with SLE to avoid these side effects and routine eye exams are done on those using HCQ to prevent retinopathy. (Plaquenil (hydroxychloroquine), 2014) (Bartels, 2016) (Mayo Clinic Staff, 2015). Systemic Lupus Erythematosus predominantly affects women. Research suggests this is due in part to estrogen. For every one man diagnosed with SLE, there are nine to twenty women diagnosed. Within the population of women who are at risk for SLE, women who are not white are at a higher risk for SLE as well as women under the age of 15 and over the age of 45. The discrepancy in race may have to do with the fact that colored females have higher recorded levels of estrogen than do white females.   Estrogen is thought to make women more susceptible to an autoimmune disease such as SLE because of its intracellular transcription ability to alter DNA. The effects of estrogen have also been studied holistically in association with the disease. Estrogen may encourage systemic inflammation in SLE and affect the severity of the disease and acute instances of it. Although estrogen has been identified as causing inflammation it has also been identified as prohibiting inflammation; thus meaning es trogen can act oppositely as it does in SLE in terms of another autoimmune disease. The discrepancy between the genders cannot completely be accounted for primarily with estrogen levels, however. Sex hormones are not the only determining factor for autoimmune diseases, others include; epigenetics, infections, genetics, and external environment. (Pierdominici Ortona, 2013, pp. 25-27) (Khan Ahmed, 2015) (Isherwood Witter, 2012) References Antinuclear Antibody (ANA). (2017, March 22). Retrieved March 23, 2017, from Lab Tests Online website: https://labtestsonline.org/understanding/analytes/ana/tab/test/ Bartels, C. M. (2016, September 19). Systemic Lupus Erythematosus (SLE) Treatment and Management (H. S. Diamond, Ed.). Retrieved March 23, 2017, from Medscape website: http://emedicine.medscape.com/article/332244-treatment Bocco, D. (2017, January 3). The Difference Between Lupus and RA (N. Carteron, Ed.). Retrieved March 23, 2017, from Healthline website: http://www.healthline.com/health/lupus-and-ra#Overview1 Corthay, A. (2009, June 27). How do Regulatory T Cells Work? Retrieved March 22, 2017, from NCBI website: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2784904/ Hampe, C. S. (2012, September 23). B Cells in Autoimmune Diseases. Retrieved March 22, 2017, from Hindawi website: https://www.hindawi.com/journals/scientifica/2012/215308/ Hansen, M. S., Schuman, S. G. (2011, June). Hydroxychloroquine-Induced Retinal Toxicity. Retrieved March 23, 2017, from American Academy of Ophthamology website: https://www.aao.org/eyenet/article/hydroxychloroquine-induced-retinal-toxicity Isherwood, D., Witter, J. (2012, July 16). Lupus fact sheet (B. Diamond, Ed.). Retrieved March 24, 2017, from Womenshealth.gov website: https://www.womenshealth.gov/publications/our-publications/fact-sheet/lupus.html Khan, D., Ahmed, S. A. (2015, December 3). The Immune System Is a Natural Target for Estrogen Action: Opposing Effects of Estrogen in Two Prototypical Autoimmune Diseases. Retrieved March 24, 2017, from NCBI website: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4701921/ Mayo Clinic Staff. (2015, November 26). Prednisone and other corticosteroids. Retrieved March 23, 2017, from Mayo Clinic website: http://www.mayoclinic.org/steroids/art-20045692?pg=2 Pierdominici, M., Ortona, E. (2013). Estrogen Impact on Autoimmunity Onset and Progression: the Paradigm of Systemic Lupus Erythematosus. International Trends in Immunity, 1(2), 24-34. Retrieved from http://researchpub.org/journal/iti/number/vol1-no2/vol1-no2-3.pdf Plaquenil (hydroxychloroquine). (2014, February 10). Retrieved March 23, 2017, from Netdoctor website: http://www.netdoctor.co.uk/medicines/aches-and-pains/a7356/plaquenil-hydroxychloroquine/ Starkebaum, G. A. (2016, January 16). Systemic lupus erythematosus. Retrieved March 23, 2017, from MedlinePlus website: https://medlineplus.gov/ency/article/000435.htm Understanding Autoimmune Diseases. (2016, March). Retrieved March 22, 2017, from National Institute of Arthritis and Musculoskeletal and Skin Diseases website: https://www.niams.nih.gov/%5C/Health_Info/Autoimmune/default.asp Venes, D., Biderman, A., Adler, E., Fenton, B. G., Enright, A. D., Patwell, J., . . . Wight, A.-A. (Eds.). (2005). Tabers Cyclopedic Medical Dictionary (20th ed.). Philadelphia, PA: F.A. Davis Company.

Sunday, January 19, 2020

Organizational Development Final Project

In preparing his paper, you will examine how the theories and models presented In this course, as well as In the literature, can be utilized to support and facilitate a planned change effort. Your focus can be within a particular organizational setting of your choice, or an industry, or a type of organizations in general (for example, non-profit, civic, for- profit). The focus could be on a specific organizational change, for example, enhancing creativity and innovation. The action plan should be written as a serious proposal to executive management about a specific planned change effort. Discuss the following elements in your proposal.As you will see, you will need to have a working knowledge of this challenge, either from literature or company documents or your own observations. 2 Introduction. Brief description of the current organizational challenge. This proposal is from your perspective, as you have not yet engaged others in this process. That said, describe the challenge from your perspective and describe your role as related to the challenge. Current State. Description of current state to Include: o What has been done to correct or address the challenge? O What is the urgency to meet this challenge? O What are the consequences of not changing?Desired Future State. Description of the desired state you wish to see in terms of this current challenge to include the following elements. Keep in mind that this is still from your perspective, as you have not yet engaged others in the DO process. Please note that if you have engaged others in this discussion, such as the manager of the department, address that in the paper. O What is the ideal state of the organization in terms of this current challenge? O What behaviors will organizational members demonstrate? O What behaviors will organizational leaders demonstrate? O What will the â€Å"changed organization† feel like (culture)?What value will this planned change effort add to the organization? Action Plan. Steps you (and others) will take to make the desired state a reality. O Change Team: Who needs to be involved in this process to ensure its success? O Brief discussion of alignment of this proposed change with organization development values and assumptions. O Describe an overall approach (strategy) for creating and implementing the change, such as Action Research, Organization Change Process. O Describe a minimum of three methods or tools you will use to assess and facilitate this planned change effort (embedded within your strategy).Describe challenges and barriers you anticipate and how you will address them. This could include organizational readiness for change, expected resistance to change, organizational leadership. Benefits. Description of benefits of this proposal. O List 3 – 5 specific results you expect from successful implementation of the plan. Option 1 for Signature Assignment 61 5 Organization Development and Change Master Syllabus rev 01 . 13. 12 page 7 o Link back to consequences of not changing. O Describe success measures that will be used (evaluation). First Step. Summarize with one specific first step.You will draw from multiple sources (minimum 5) including Journal articles, books, and professional references such as associations and websites (this will help place your proposal within the framework of what others have done to address the challenge. ) You may also draw from class discussions and activities, as well as your own experience within organizational settings. Look for ways to integrate organization development with other leadership theories and concepts discussed in organizational leadership (drawing from other OLL, HRS, HA courses and/or 613 Dynamics of Organization Behavior). Page 8

Friday, January 10, 2020

Cadet Entrance Response Essay

Compose your own response. What are the most important qualities in becoming a successful USMA cadet and a successful Army officer? Resilience, dedication and leadership are qualities befitting for a successful USMA cadet and a successful Army officer. Resilience is not only an essential quality for becoming a successful cadet or officer, it is also essential for your life. Resilience is the ability to resurrect one’s self from hard times, to never give up, and displays ones mental strength. In the academy I’ve heard that on a cadet’s first year they undergo times of overwhelming stress in tests of emotional stability, perseverance, and ability to organize and perform under stress. With resilience and resolve a cadet will be able to overcome these stressful obstacles. Likewise, discipline is another quality in becoming a successful USMA cadet and a successful Army officer. At times resilience may complement dedication because when one dedicates their self to something, one needs the resolve to continue on with it and never give up. Dedication shows ones loyalty, commitment, and devotion, in which is an important trait when offering one’s service to their country. To finish, a successful USMA cadet and Army officer should have the quality of leadership. As a leader one must offer guidance and work together as a team to get things done efficiently. Leadership brings out control and order in a group. Showing resilience and dedication as a leader conveys a sense of trustworthiness and cooperation among their followers. Any person with a position of leadership needs to set a positive example in order to make their self charismatic and a successful leader. Having these qualities will show the mental strength, devotion, and management skills it takes in becoming a successful USMA cadet and Army officer.

Thursday, January 2, 2020

Legalizing Marijuana For Open Recreational Use - 1261 Words

In 2014, Florida joined the growing ranks of states that have found themselves engaged in the legislative and moral debates regarding whether the time has arrived to legalize the possession, distribution, and use of marijuana for medicinal and/or recreational use. While hotly debated on both sides, one of the more ironic factors regarding the issue of legalization is that it was found to be perhaps the most logically and fairly debated topics of the state’s recent mid-term elections. The facts of legalization are becoming more black and white and less about morality, which may be a testament to why 24 U.S. states and the District of Columbia have enacted laws legalizing medicinal marijuana. Of those states, Alaska, Oregon, Washington, and Colorado have also legalized marijuana for recreational use. Although the idea of legalizing marijuana for open recreational use may further incense opponents of its government sanctioning, it can also be contended that doing so only give s state and federal entities a better ability to monitor how marijuana is being distributed and removes a great deal of the temptation or necessity for users and distributors to use subvert the process of medicinal dispensing to obtain cannabis for recreational consumption. This issue also creates a new angle on states’ rights, as each state is legally able to enact its own policies and laws, yet the federal government can ultimately intervene and determine any state’s legislation to be illegal.Show MoreRelatedShould Marijuana Be Legalized?1149 Words   |  5 PagesJacomino English 1410 23 March 2015 Legalizing cannabis Marijuana or cannabis is a preparation of the cannabis plant intended for use as a hallucinatory drug and a medicine as well. 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