the issue of what physicians turn to when asthma is persistent.

Your assignment is to prepare and submit a paper on crtical apprisal 2. LTRA is the main subject of this paper by Currie, et al.

This study is focused because it clearly states its target population of concern which is patients with persistent asthma. Secondly it addresses the issue of what physicians turn to when asthma is persistent. Specifically, these are LTRA and LABA. These two play a very important role as they are legally administered and known second line therapy. In the UK, their guidelines state that in the first instance, LABA should be administered as a therapeutic trial. If this is unsuccessful, then this is the time to administer LTRA. Third, outcomes are clearly defined. Physicians give inhaled corticosteroids when a patient is diagnosed with asthma. For persistent symptoms, they choose to introduce LABA. This is known to be more effective than an increase in dosage of the inhaled corticosteroids. Additional therapy with LTRA is presented to be more effective than LABA in its overall efficacy.

Only appropriate, related and relevant papers and journals were included in this review article. In fact, in the material and methods section of this paper, the researchers pointed out that they searched for suitable trials with its relevance evident in the title and abstract. This therefore implies that no literature included used LTRA or LABA as a secondary topic. Researchers focusing on these were included and not those that just merely mentioned the two. The data base used MEDLINE Clinical Evidence, Cochrane Library and EMBASE database, are supported by reputable organizations.

The research for significant literature also had key guidelines limiting searches to about 11 words. This definitely narrowed down the search and only produced crucial and relevant journals that are directly related to the research topic. A statistical analysis was not used. Certain data from the studies were taken and reviewed.

Entitlement Programs and the handicaps that go along with having them.

Write 14 pages with APA style on Entitlement Programs and the handicaps that go along with having them. Becаuse the mаjority of leаvers аre working, it is not surprising to find thаt eаrnings from work is the most common source of income for leаver fаmilies. However, mаny leаver fаmilies аre аlso receiving income from other sources, including eаrnings from other fаmily members, child support, government disаbility benefits, food stаmps, аnd help from fаmily аnd friends. The mаjority of leаver fаmilies hаve some reliаnce on eаrnings аs а form of income. Sixty to 70 percent hаve income from their own eаrnings. In аddition, mаny leаver fаmilies hаve eаrnings from other fаmily members. Five studies report the percent of leаver fаmilies thаt hаve eаrnings from аny fаmily member, with reports rаnging from 64 percent in the District of Columbiа to 80 percent in Missouri. Child support is аnother source of income for leаver fаmilies, since аll of these fаmilies hаve children аnd mаny of them аre single-pаrent fаmilies. In six out of the eight studies with informаtion on receipt of child support, more thаn 20 percent of leаvers report this source of income. In Mаssаchusetts, however, neаrly hаlf of аll leаvers (46 percent) sаy they hаve some income from аn аbsent pаrent.

Discus Marx and Smith’s Views on Capitalism.

Write 5 pages with APA style on Marx and Smith’s Views on Capitalism. Capitalism as viewed by a smith using Locke’s theory to have benefited society through the field of commerce, making the society more organized and well balanced the self-interest of individuals makes them work for the chances available. His reasoning in line with locks theory is that in case there was equality in distribution of the collective wealth to the laboring society then, the effect would not still be effective enough to provide material comfort. He, therefore, views capitalism to be better for the laboring society in general by rewarding the efforts of productive labor. This is done as per the productivity of the laborer hence encourages more productivity.

Reasons for investing in productive labor under capitalism

Productive labor is referred to be the labor, which adds value to the subject of the undertaking. It is advisable to employ those who add value more than those who add no value to the subject in order to be rich. Everyone is maintained by the labor of the society. thus, productive labor gives a bigger hand in these efforts. The produce of the land and the efforts of the productive labor directly or indirectly cater to the people’s maintenance thus becomes the basis of capitalism, since, through this way, the capital is replaced.

What capitalists should do to increase the productiveness of labor?

The capitalist should ensure the division of labor among the community members and increase employment of productive labor this will ensure a general effect of understanding the general business of the society better. The division of labor eliminates the effect of using a small number of employees by a manufacturing firm to undertake different duties in different places. Rather, more employees are employed in different sectors thus effective overall performance. The various laborers should be assigned to perform duties that they are used to and have skills in instead of letting them become players in all fields.

Division of labor and its effectiveness

Division of labor improves the productive power of labor. It improves judgment and skill application hence an overall effect of better performance. Work that could be carried centrally or by a single operator is divided into several others hence becomes a process.

This week, you will be learning about different gynecological cancers .? We will begin by reviewing the pathophysiology and progression of the di

This week, you will be learning about different gynecological cancers .? We will begin by reviewing the pathophysiology and progression of the di

This week, you will be learning about different gynecological cancers .  We will begin by reviewing the pathophysiology and progression of the disease. As a clinician, you will be responsible for screening patients and helping co-manage their diseases. You will identify  risk factors and prevention measures to help improve health. To complete this soap note you will have to follow the template attached to this post. The soap note has to be done as if a pt came in with symptoms of possibLe endometrial cancer and then lead up to a diagnosis of endometrial cance. please use references in app style and no Later then five years ago. 

SOAP NOTE

Name: Date: Time: Age: Sex: SUBJECTIVE CC:

Reason given by the patient for seeking medical care “in quotes”

HPI:

Describe the course of the patient’s illness, including when it began, character of symptoms, location

where the symptoms began, aggravating or alleviating factors; pertinent positives and negatives, other

related diseases, past illnesses, surgeries or past diagnostic testing related to present illness.

Medications: (list with reason for med )

PMH

Allergies:

Medication Intolerances:

Chronic Illnesses/Major traumas

Hospitalizations/Surgeries

“Have you every been told that you have: Diabetes, HTN, peptic ulcer disease, asthma, lung disease, heart

disease, cancer, TB, thyroid problems or kidney disease or psychiatric diagnosis.”

Family History

Does your mother, father or siblings have any medical or psychiatric illnesses? Anyone diagnosed with:

lung disease, heart disease, htn, cancer, TB, DM, or kidney disease.

Social History

Education level, occupational history, current living situation/partner/marital status, substance use/abuse,

ETOH, tobacco, marijuana. Safety status

ROS General

Weight change, fatigue, fever, chills, night sweats,

energy level

Cardiovascular

Chest pain, palpitations, PND, orthopnea, edema

Skin

Delayed healing, rashes, bruising, bleeding or skin

discolorations, any changes in lesions or moles

Respiratory

Cough, wheezing, hemoptysis, dyspnea, pneumonia

hx, TB

Eyes

Corrective lenses, blurring, visual changes of any

kind

Gastrointestinal

Abdominal pain, N/V/D, constipation, hepatitis,

hemorrhoids, eating disorders, ulcers, black tarry

stools

Ears

Ear pain, hearing loss, ringing in ears, discharge

Genitourinary/Gynecological

Urgency, frequency burning, change in color of

urine.

Contraception, sexual activity, STDS

Fe: last pap, breast, mammo, menstrual

complaints, vaginal discharge, pregnancy hx

Male: prostate, PSA, urinary complaints

Nose/Mouth/Throat

Sinus problems, dysphagia, nose bleeds or

discharge, dental disease, hoarseness, throat pain

Musculoskeletal

Back pain, joint swelling, stiffness or pain, fracture

hx, osteoporosis

Breast

SBE, lumps, bumps or changes

Neurological

Syncope, seizures, transient paralysis, weakness,

paresthesias, black out spells Heme/Lymph/Endo

HIV status, bruising, blood transfusion hx, night

sweats, swollen glands, increase thirst, increase

hunger, cold or heat intolerance

Psychiatric

Depression, anxiety, sleeping difficulties, suicidal

ideation/attempts, previous dx

OBJECTIVE

Weight BMI Temp BP Height Pulse Resp General Appearance

Healthy appearing adult female in no acute distress. Alert and oriented; answers questions appropriately.

Slightly somber affect at first, then brighter later. Skin

Skin is brown, warm, dry, clean and intact. No rashes or lesions noted. HEENT

Head is normocephalic, atraumatic and without lesions; hair evenly distributed. Eyes: PERRLA. EOMs

intact. No conjunctival or scleral injection. Ears: Canals patent. Bilateral TMs pearly grey with positive

light reflex; landmarks easily visualized. Nose: Nasal mucosa pink; normal turbinates. No septal deviation.

Neck: Supple. Full ROM; no cervical lymphadenopathy; no occipital nodes. No thyromegaly or nodules.

Oral mucosa pink and moist. Pharynx is nonerythematous and without exudate. Teeth are in good repair. Cardiovascular

S1, S2 with regular rate and rhythm. No extra sounds, clicks, rubs or murmurs. Capillary refill 2 seconds.

Pulses 3+ throughout. No edema. Respiratory

Symmetric chest wall. Respirations regular and easy; lungs clear to auscultation bilaterally. Gastrointestinal

Abdomen obese; BS active in all 4 quadrants. Abdomen soft, non-tender. No hepatosplenomegaly. Breast

Breast is free from masses or tenderness, no discharge, no dimpling, wrinkling or discoloration of the skin. Genitourinary

Bladder is non-distended; no CVA tenderness. External genitalia reveals coarse pubic hair in normal

distribution; skin color is consistent with general pigmentation. No vulvar lesions noted. Well estrogenized.

A small speculum was inserted; vaginal walls are pink and well rugated; no lesions noted. Cervix is pink

and nulliparous. Scant clear to cloudy drainage present. On bimanual exam, cervix is firm. No CMT.

Uterus is antevert and positioned behind a slightly distended bladder; no fullness, masses, or tenderness.

No adnexal masses or tenderness. Ovaries are non-palpable.

(Male: both testes palpable, no masses or lesions, no hernia, no uretheral discharge. )

(Rectal as appropriate: no evidence of hemorrhoids, fissures, bleeding or masses—Males: prostrate is

smooth, non-tender and free from nodules, is of normal size, sphincter tone is firm). Musculoskeletal

Full ROM seen in all 4 extremities as patient moved about the exam room. Neurological

Speech clear. Good tone. Posture erect. Balance stable; gait normal. Psychiatric

Alert and oriented. Dressed in clean slacks, shirt and coat. Maintains eye contact. Speech is soft, though

clear and of normal rate and cadence; answers questions appropriately.

Lab Tests

Urinalysis – pending

Urine culture – pending

Wet prep – pending

Special Tests

Diagnosis

Differential Diagnoses

o 1- o 2- o 3-

Diagnosis

o

Plan/Therapeutics

o Plan: ▪ Further testing ▪ Medication ▪ Education ▪ Non-medication treatments

Evaluation of patient encounter

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