Case Study 5: Mental Disorders

1. Mental disorders and mental illnesses are two different conditions, however they have similarities and differences, which distinguishes them. Mental illness is a neurotic brain condition which is characterized by signs and symptoms, and mainly occurs due to etiological conditions such as infections or environmental factors. A mental illness tends to be acquired through biological means, and not through natural occurrences. Thirdly, a mental illness affects the general functioning of the mind, through affecting certain areas of the brain (Corcoran, 2011). On the other hand, mental disorder is the changes which take place in a person’s daily activities, thus affecting the general functioning of the mind. This may be due to post traumatic stress disorder, or due to anxiety and fear. The victim may however recover with time, based on the effectiveness of the stressor. A good example is anxiety due to failing the exam a move which leads to stress, but the victim can later on recover (Flamez & Sheperis, 2016).

The two conditions, mental illness and mental disorder have similarities, which include the following: victims of both conditions tend to feel sad, to be worried, and to withdraw from their friends and other activities (Schatzberg & Nemeroff, 2009). These feelings tend to affect the victims, making them to feel detached from other people, a move which makes them to result into committing suicide or to end up killing other people. Mental disorders and mental illnesses may not also be easily distinguished, because of similar signs and symptoms (Corcoran, 2011).

2. Adam Lanza’s engagement with violent video games and novels affected his mind-set, thus leading to stress, which made him to execute the killings. A mental disorder is usually caused by factors which surround us, thus affecting our reasoning and the way we do different things. Adam was a teenager when his parents divorced, a move which really affected the way he behaved (Flamez & Sheperis, 2016). The divorce affected his brain functioning a move which made it hard for him to be able to live peacefully as before. Similarly, the books which Adams read, affected his actions, a move which prompted him to commit the murder (Spina & Trifirò, 2016). The books contained information which was highly related to the incident, thus explaining the reason as to why Adams killed his mother together with the children. Furthermore, Nancy’s house was loaded with ammunitions, a move which prompted Adams to execute the killings with the aid of the weapons which were at his disposal (Schatzberg & Nemeroff, 2009).     

Adam could have been a good candidate of treatment had he not committed suicide, because of the ways he was responding positively to the medication. Adam was responding positively to the treatment, however, his mother decided not to stop the medication, after claiming his son was unable to raise his hand (Corcoran, 2011). The medication was good for the teenager, and it could have allowed him to be able to change his behaviour (Spina & Trifirò, 2016). In addition, Adam could have changed with time, and he could have also shared his experiences with his mother, thus avoiding committing suicide. 

3. Psychologists should have administered psychotropic medications to young Adams, since this medication is good for dealing with the moods and behaviour of the child (Flamez & Sheperis, 2016). Adam could have therefore been able to easily communicate to his parents about the effects of the medication on his body, or how he felt after taking the medication. After a short period of time, he could have been able to fully recover from the condition, a move which could have allowed him to avoid killing people (Corcoran, 2011). Moreover, due to changing the behaviour of the child, Adam could have been able to avoid reading novels related to serial killings, a move which could have allowed him to be able to change hence not committing such actions.

In as much as psychotropic medications are good for dealing with mental disorders amongst children, the drug has its challenges, and this includes body growth and heart beat rate (Schatzberg & Nemeroff, 2009). In order to deal with this, the medication should be administered in low doses, and the doctors should also check on the way the he reacts to the medications to ensure the effects of the medication do not get out of hand (Flamez & Sheperis, 2016).    

4. According to my point of view, minor mental illnesses and functional mental illnesses are not as serious as compared to manic depressive behaviour (Corcoran, 2011). People suffering from manic depressive behaviours tend to suffer from a lot of challenges, which include eating disorders, impulse control disorders, fictitious disorders and dissociative disorders (Spina & Trifirò, 2016). On the other hand, minor mental illnesses and functional mental illnesses have similar characteristics such as mood changes, and anxiety which are not mild. This makes it hard for the victims of this conditions not to suffer a lot. Manic depressive behaviour is however a very serious condition, as it might lead to other serious illnesses, particularly because people with such conditions tend to experience high sexual desires. This consequently makes the victim sexually active, thus leading to the spread of other disease if the victim indulges in sexual intercourse with multiple partners without protection (Flamez & Sheperis, 2016).

Reference

Corcoran, J. (2011). Mental health treatment for children and adolescents. Oxford: Oxford University Press.

In Flamez, B., & In Sheperis, C. (2016). Diagnosing and treating children and adolescents: A guide for mental health professionals.

Schatzberg, A. F., & Nemeroff, C. B. (2009). The American Psychiatric Publishing textbook of psychopharmacology. Washington, D.C: American Psychiatric Pub.

In Bezchlibnyk-Butler, K. Z., In Elbe, D., In Procyshyn, R. M., & In Virani, A. S. (2014). Clinical handbook of psychotropic drugs for children and adolescents.

In Spina, E., & In Trifirò, G. (2016). Pharmacovigilance in psychiatry.

Why Marijuana should be Legal in Connecticut for Medical and Recreational use

Legalization of marijuana comes with a lot of advantages both to the state and to the country in general. Marijuana contains a lot of chemicals, which can be used in the treatment of different diseases (Barbour, 54). For instance, marijuana can be used for medical purposes, particularly for the treatment of cancerous diseases, and post-traumatic stress disorders. In addition, legalization marijuana a lot of economic benefits, since the country gets to benefit from the sale of marijuana products in different parts of the world (Caulkins, Kilmer & Kleiman, 34).

The health of marijuana smoking are not as worse as those of cigarette smoking or alcohol drinking, since marijuana only makes a person’s body to function differently, but it does not harm (Barbour,54). In addition, marijuana has not been proven to cause cancer, and most people who smoke marijuana tend to live longer compared to those who smoke cigarette and drink alcohol. In the U.S, 88% of the total population has abused marijuana, a move which clearly shows how common marijuana smoking is in the country (Caulkins, Kilmer & Kleiman, 34).

The U.S government spends over $20 billion every year, while fighting illegal smuggling of marijuana in the country (Barbour, 57). Even though the government spends a lot of money in fighting illegal smuggling of marijuana, more people are easily accessing the drug. In addition, the number of people arrested because of the violation of drug law is 1,488,707 (Caulkins, Kilmer & Kleiman, 35). This is the highest number of incarcerations related to marijuana ever made in the whole world. The government consequently spends more money, in the upkeep of the criminals in prisons, a move which affects the economy of the country (Goldberg, 70).   

Legalization of marijuana would allow Connecticut to be able to earn huge revenues, amounting to $1 billion every year (Barbour, 60). This is basically because of the high demand of medical marijuana products all over the world. Moreover, the country will be able to save up to $8.7 billion each year, as it will reduce the amount of money spent on fighting illegal smuggling of marijuana (Caulkins, Kilmer & Kleiman, 38). The number of marijuana related arrests will also drop drastically, allowing the country to reduce the expenses of catering for criminals in prison. The country’s economy will grow rapidly, as the levels of inflation will drop (Goldberg, 70).

Legalization of marijuana comes with creation of job opportunities, which is an advantage to the population of both Connecticut and the US in general (Goldberg, 76). Laboratories and clinics will be set up in order to control and research of marijuana products, thus coming up with more medical uses of the drug. This will consequently require the employment of qualified personnel in this sector, who will be required to conduct the research (Caulkins, Kilmer & Kleiman, 39).

Legalization of marijuana comes with a lot of challenges, and strict measures should be put in place in order to regulate the sale of marijuana products to the public. The government will be required to come up with measures, such as giving permits to a certain number of marijuana farmers, who will be required to plant marijuana for medical purposes only. In addition, marijuana should also be sold to adults from the ages of 21 years and above (Caulkins, Kilmer & Kleiman, 40). Marijuana products should have a standardization mark of quality, which will distinguish them from those of pirated products. Specific clinics should also be allowed to sell the products, and marijuana should only be smoked in specific allocated smoking zones, to make sure people of a younger age do not get access of the drug (Barbour, 62). In so doing, the country will be able to fully benefit from the legalization of marijuana without having any threats at all.

Work Cited

Caulkins, Jonathan P, Beau Kilmer, and Mark Kleiman. Marijuana Legalization: What Everyone Needs to Know. , 2016. Print.

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Barbour, Scott. Should Marijuana Be Legalized?San Diego, CA: ReferencePoint Press, 2011. Print.

Goldberg, Ray. Drugs Across the Spectrum. Belmont, CA: Wadsworth, Cengage Learning, 2010. Print.

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Case Study on Death and Dying

            Abstract

Every day healthcare professionals are faced with the dilemma of making decisions where cultural or religious diversity is involved. In this context, there is a need to understand the diversity of cultures and religions in providing quality and reliable care. The society today is characterized by a widened range of distinct beliefs in relation to culture and religions that are bound to affect health care operations while providing healthcare services. Given that this is the case, most nurses are required to understand and respect every culture or even belief in which they interact with. This paper will provide an analysis of two different religions on the ground of worldview perceptions and the provided case study. The religions that will be discussed as Buddhism and Christianity given that they are characterized by abundant differences, via which ethical recommendations for the case will be developed. Finally, a personal reflection is provided towards the ideal ethical considerations.

Introduction

Based on the extensive range of fears in life, the subject of dying or death is a complex and a challenging one for most individuals to flexibly deliberate. It is apparent that dying is a common and unavoidable part of universal existence for everything that has life but the subject of death remains to be distasteful to several cultures (Bregman, 2010). Nurses in their everyday operations interact with patients from differentiated faith backgrounds and therefore it is highly essential to deliver quality services that are respectful and sensitive to differing cultures. Further, the understanding of the diversity is useful in assisting the affected people to progress through the dying and death procedure with an inclusion of ethical decisions.

Brief Christianity overview

In reference to Christianity believes, the decisive and solitary main authenticity remains to be God. In this main authenticity, main can best be described as the introductory significance in the life of an individual while the authenticity refers to a tangled thing that is present in humans. In this context, in Christianity God and all his standards should at all times be accounted first within all operations in life and when making decisions. God is therefore considered to be the head of human life and in all things, he dominates (Bregman, 2010). The Christian belief is that in all the saying and doings God should come first as the owner of all things to which they must be in respect with.

Worldview Principles

Prime reality can best be described as placing the most important things in individual’s life based on the human foundation. For Buddhism prime reality offers a description that all the things are good and therefore categorized as objective being, which can be defined as an energy of awareness or existence (Coward & Stajduhar, 2012). On the other hand, in Christianity, the actual authenticity refers to God. God, in this case, is the base, the motive for life and therefore every action should be objected at generating credit in his honor. The external authenticity refers to the faith of how the universe was formed and the materials that surround humans. Christianity operates on the conviction that the world was created in about a week and the creation was based on a purpose. On the other hand, Buddhism generates the conviction that the universe holds no value and therefore their main objective is to escape from the universe as head to Paradise (Coward & Stajduhar, 2012).

In relation to Christianity, the status of the external authenticity, and everything that covers them is the world and in this context, everything in it was created by God (David, 2006). In that, God was involved in the creation of the world and guidelines which control and manages the universe for individuals to exist and accept these regulations. In Christianity, the universe’s nature which surrounds humans is perceived as a gift from the creator who is God, and this aptitude must be favored and respected (David, 2006). Based on Christian’s faith, the universe is a product of God’s words, and therefore even life was never created from the visible things.

In worldviews principles, the diversity of human beings and their beliefs is responsible for the creation of purposes and convictions. In that Christians believes that individuals were created in as God's reflection and their purpose are to spread his world to save more souls who will eventually occupy heaven (David, 2006). In Buddhism, this conviction differs as humans are the ones that possess god an aspect that is obtained via extensive meditation and rejecting earthly desires. This is additionally, directed by principles that seek to take individuals to paradise after living and the entire procedure through which salvation is acquired. Buddhism beliefs follow a more strict sequence of being reborn and reawakening. These principles are, however, based on the individual’s conduct fueled by the things that they did and those that they reject in their present life. With respect to the sequence, if one is fruitful in the present existence and acquires all the enlightenment steps this will eventually lead to them being in paradise as payment for their desirable productivity (Setta & Shemie, 2015).

George’s Morally Justified Options under Both Religions

For Christians George’s suffering would be interpreted as the willpower of God. Jesus’s death plays an integral role in Christianity and most individuals criticize this conviction by stating that it is an adoration of misery and a fascination with death. However, for Christians, they believe that it is God that offers life to humans and is the only individual that has the authority of taking it. They would, therefore, interpret it as a trial of his faith where he is therefore supposed to remain strong and let his wishes prevail. On the other hand, Buddhists would interpret it as suffering that is based on the things that he failed to accomplish or the incapability in his life to reject earthly pleasure. Buddhism is driven by the principle that the good and the undesirable things are paid by God in the present or the life acquired after death (Pappas, 2012). In this context, individuals are actually required to be respectful and fruitful and adequately reject or the earthly related pleasure so that their rebirth can be honored a failure that leads to suffering (Setta & Shemie, 2015). Both religions would reject euthanasia given that they consider life as precious and owned by God.

Case evaluation and interpretation of George’s suffering

With respect to the lack of cure for ALS and the possible effects, George opts for euthanasia. For Buddhist, the rationale being George’s suffering is based on his deeds. In that the religion advocates for desirable behavior that are fruitful in acquiring a treasurable life. Buddhist mainly considers life as a major suffering and therefore, it is only via desirable deeds that one can access heaven which is the status of the utmost meditation (Purvis, 2012). This is accounted to be the most undesirable terror that one can be situated at. On the other hand, Christianity does not believe in penalty for deeds where the suffering can, therefore, be interpreted as trial that every individual has to pass through although differently (Purvis, 2012). In that God does not subject suffering to sinners but to everyone. In the perspectives of Buddhism, euthanasia can never be feared because a rebirth will occur, while Christians would reject the option on the ground that human life is of extensive value and must be preserved. The justified option under Christianity is to support him and take care despite the challenges and allow the will of the highest to prevail while Buddhists do not fear death.

Self-reflection

In my opinion, I do believe that the morally justified option is to preserve his life and take care of him regardless of the probable outcomes. This is because life is in itself very precious and should be preserved at all times. No one has the right of deciding when life should start given that the authority of controlling the beginning and end lies in God’s hand. In this context, George should be allowed to live and to be given all the attention and medical options that seek to stabilize him without biases. Despite the lack of cure for the ailment, this does not imply that he should die to end suffering rather the suffering can be lowered by loving and offering support.

Conclusion

Worldviews differ in reference to the extensive religious and cultural differences in the society today. In this context, there is no right or undesirable action in which beliefs should be based upon given that everyone has the right to thoughts ownership. Therefore, in the quest of living superior lives, there is a need to understand the diversity of beliefs and how effective coexistence and work can be accomplished. In spite of the differentiated beliefs, standards, and morals it is the differences that make everyone unique and therefore, in creating healthcare efficiency individuals should learn to embrace diversity moderately than trying to modify them to fit with our one.

References

Bregman, L. (2010). Religion, death, and dying. Santa Barbara, Calif: Praeger.

Coward, H. G., & Stajduhar, K. I. (2012). Religious understandings of a good death in hospice palliative care. Albany: State University of New York Press.

Pappas, D. M. (2012). The euthanasia/assisted-suicide debate. Santa Barbara, Calif: Greenwood.

San F. Davd. (2006). “Religious Interpretations of Death, Afterlife & NDEs". Faculty Publications. Paper 32. http://digitalcommons.nl.edu/faculty_publications/32

Susan M. Setta & Sam D. Shemie. (2015). an explanation and analysis of how world religions formulate their ethical decisions on withdrawing treatment and determining death. Doi:  10.1186/s13010-015-0025-x

Taylor E. Purvis. (2012). Debating Death: Religion, Politics, and the Oregon Death with Dignity Act. Yale journal of biology and medicine. 85(2): 271–284.

Health

The north/the south divide in health implies the difference between the production of health services in developed countries, which are in the north divide and the developing countries which are in the south divide. The provision of health services in the two divides is different, thus leading to major differences between these countries (Mphande, 2016). The north divide consists of countries which are able to provide healthcare services without any problems at all. On the other hand, the south divide consists of countries which face a lot of challenges in the provision of healthcare services.

The leadership of developing countries can take a lot of steps in ensuring the provision of healthcare services becomes easy (Mphande, 2016). The first step can be through the provision of mobile clinics. Mobile clinics can be very effective, due to the issues of poor transport and infrastructure in developing countries. A mobile clinic can move from one area to another, thus ensuring the provision of healthcare becomes smooth, particularly in areas where there are no hospitals.

Secondly, the government through the ministry of health can reach people through workshops, whereby people will be taught on how to conduct first aid, in case of a health problem. In addition, the workshops will also teach the society on the importance of seeking medical advice (Mphande, 2016). Finally, most people will be able to see the need to seeking medical advice, in addition, they will also be able to provide assistance to the sick through first aid, before reaching the hospital. In general the developing countries will be able to provide medical support to most people through the mobile clinics and the workshop, hence improving the health of the nation.      

Reference

AFRICOMM 2011, & Popescu-Zeletin, R. (2012). E-infrastructure and E-services for Developing Countries: Third International Icst Conference, Africomm 2011, Zanzibar, Tansania, November 23-24, 2011, Revised Selected Papers. Berlin: Springer.

Mphande, F. A. (2016). Infectious diseases and rural livelihood in developing countries.

Changing Trends in Suicide

There are three types of suicide according to chapter 10 of the textbook, which are: egoistic suicide, altruistic suicide and anomic suicide. Egoistic suicide is the type of suicide committed by a person who feels detached from the society, and this may include stigmatization. Altruistic suicide is a type of suicide where one is very much involved in the dictates of a group, than in his own. The person may therefore take his or her life to impress the group (Diamond, 2011). A good example being suicide bombing, whereby one becomes the suicide bomber. Anomic suicide is a type of suicide where one decides to take own life due to stress, either through failing to reach certain goals.

Criminalization of suicide would be reasonable, as it would prevent most people from committing such acts. In addition, people will seek different ways of dealing with their personal issues rather than ending their lives (Diamond, 2011).

A suicide can only be considered mental illness, if the victim had any mental problem prior to committing suicide, if the victim had been diagnosed any mental problems and treated, and if the victim showed signs of mental issues (Diamond, 2011). In intentional acts, experts may exam the challenges facing the victim, and this may include social problems, financial issues and being involved in extremist groups. Determining if a suicide is a mental suicide is significant in the sense that it helps in allowing the victim, if he or she did not dies, with the right medication of dealing with the mental problem. On the other hand, failure of not recognizing if the suicide was intentional or not may lead to increase in rates of criminal activities, since a criminal may kill a person and make it to look as if it was a suicide.

Reference

Diamond, J. M. (2011). Collapse: how societies choose to fail or succeed.

Functional Alcoholism

The standards of use of sobriety test and chemical are too subjective for an officer to use, in the sense that the officer might use them as means of imposing more charges on a driver. A driver with a simple mistake such as swerving unintentionally may be forced to do different sobriety tests, which he or she might fail, not because of being under the influence of drugs, but because of the harshness of the police towards the driver (n.w, 2015). In addition, in chemical test, a driver who might have used drugs a day before the incident, may have traces of alcohol in his or her blood a move which might lead to accusation of DUI. 

A judge can refuse to use either chemical and sobriety tests in a court of law, particularly when the driver has not committed the mistake frequently or before. In addition, if the car in which the driver was driving there were no children, nobody was injured during the incident, and no property or vehicle was involved in the accident (n.w, 2015). This makes the officers case null, thus the judge cannot allow the use of either sobriety or chemical test in a court of law.

Alcoholism cannot be considered as a disease, since increased dependence on alcohol leads to the development of a disease. Alcoholism is not a disease it is however an agent of a liver disease known as liver cirrhosis (Flowers, 2010). If alcoholism can be detect before it gets out of hand, then it cannot lead to the development of a disease. Alcoholism can therefore be reduced or be done away with through advising people on the negative effects of alcohol. In addition, the society should also teach and educate the youths on the importance of abstaining from alcohol and drugs.

Reference

n.w. (2015). DUI Offense Basics: Find Law. Retrieved from: http://dui.findlaw.com/dui-charges/dui-offense-basics.html

Flowers, W. D. (2010). Alcoholism/drug addiction: A disease or not! : what causes alcoholism and drug addiction.

Skinny Repeal of ACA (Obamacare) and the Effects on Business Going Forward

The affordable care act is a huge economic deal, similar to any other federal law that subjects a thousand billion into some of its major sectors. One of the major dilemmas is on the sustainability of the policy by the government given that it seeks to expand the national health coverage. Even though it is unclear on how the law can be replaced one thing that most individuals agree on is that the removal or reduction of the huge portion of ACA expenses which depends on the development of Medicaid and private insurance subsidies is bound to enhance both macro and micro-economic situations (Gambino, &Jacobs, 2017). However based on the most recent data this belief is doubtful based on a collection of major intelligences which illustrates that a repeal of some of the major aspects of the policy, which makes enormous contributions to the local as well as national economies will result in the loss of millions of contracts and jobs which will not only affect the businesses but also the economic state (Newkirk, 2017).

ACA cost reduction is a negative move that is bound to impact individuals and the larger populace on the state scope. The rejection of the policy is the healthy move for the wellness of the nation’s economy. In that curbing, the healthcare insurance subsidies will affect individual’s growth which will even discourage citizens from maintaining their covers. There is no law that has the ability to account and fix all the occurring economic losses that the repeal can cause on common citizens. The losses that the repeal and replacement will cause are particularly significant economically, specifically considering the amount of investment that the policy makers. Newkirk, (2017) noted that amid 2019 and 2023 it is anticipated that the federal will acquire funds accounting for approximately 800 billion dollars which indicate that ACA’s investment occupies a considerable economic generation.

To measure the general impacts of ACA within the health sector is particularly hard but the irresistible findings by the recent studies demonstrate that Medicaid’s suitability makes individual’s intellectual, financially, psychologically and bodily better. If the repeal is based on the belief that more preventative measures should be taken rather than subsidizing healthcare then there are other suitable initiatives to handle such issues. In that, the elimination of regular healthcare access is an opposing thought that will affect the stability of businesses due to economic instability (Appleby, 2017). The insurance sector is bound to suffer more and the proposal would result in discouraging healthy individuals from maintaining the covers for the health market which would, in turn, increase the related costs and this would lead eventually to the collapsing of ACA system which will affect the national health and economic production.

It is apparent that operating within a system that permits individual’s to make coverage purchase only during the times they require them triggers the rise of costs for every individual. The policy does not only seek to improve the national health but this will lead to the advancement of the economy which is dependent on the business and economic production. The repeal is bound to weaken the general protection of the citizens who are a very weak economy and the loss of job which thus lead to a reduction of revenue.

References

Appleby, J. (2017). What Happened When These States Implemented A Skinny Repeal Of Affordable Care Act? Retrieved from http://www.pbs.org/newshour/rundown/happened-states-implemented-skinny-repeal-affordable-care-act/

Gambino, L. & Jacobs, B. (2017). Senates Rejects Bill To Repeal Large Parts Of Obamacare Without Replacement. Retrieved from https://www.theguardian.com/us-news/2017/jul/26/skinny-repeal-obamacare-senate-republicans-healthcare

Newkirk, V. (2017). Repealing Obamacare Could Kill Jobs. Retrieved from https://www.theatlantic.com/politics/archive/2017/01/obamacare-economic-effects-repeal/512618/

Sudden Infant Death Syndrome, Apparent Life-threatening Events

Pathophysiology

There are a lot of controversies surrounding SIDS pathophysiology. Three dominant post-mortem findings include the following: heart with unclotted blood, intrathoraic petechiae, and heavier organs filled with fluids. However, these findings are not concrete enough to provide a clear understanding of SIDS final pathology (Byard & Byard, 2010). The currently shunned theory, the ‘apnea theory’ which was proposed in the year 1970, helped in bringing about years and years of research and the emergence of apnea nursing industry. Nonetheless, in the index scenario which first impelled investigation of the association between SIDS and apnea, the new born was killed by the mother after confession (Acton, 2012). Current research however states that, SIDS is the concluding common path of three corresponding factors. A child must have a primary and then be stressed by an exogenous source.  Finally, SIDS can only occur in a period of a life-threatening growth period (Marx, 2010).  

Epidemiology    

2 out of 1000 live births is likely to be to be affected by SIDS. In some new-born categories occurrences of SIDS may be more than in the total population (Acton, 2012). These sorts concern sibling and the twin of SIDS victims, untimely infants, and intra-uterine infants with drug exposure. Male infant as compared to female infants, are at high risk of exposure. In addition, a genealogically temperament has also been suggested: both black and Indian infants are prone to exposure, whereas other Asian infants are at a reduced risk (Byard & Byard, 2010).

Physical Exam Findings     

At the scene of death, a closer look should be taken thus examining for the signs of impediment of the external airways, unintentional frame-up of the head, or other environmental factors which may have led to the death (Acton, 2012). After a transitory resolute unexplained events, most patients extant the emergency department in no acute distress. Out of 50% of the infants, the physical examination is usually normal. Out of the total number of patients in the emergency department, 25% of them tend to be documented with pyrexia (Marx, 2010). However, BRUE and ED might not be very effective ion providing the real cause of the death of an infant, hence more examination should also be conducted to ensure clear observations and inferences are made (Byard & Byard, 2010).

Differential Diagnoses and Rationale

Different causes of death which may include infection, innate faults of metabolism, electrolyte abnormalities, and child abuse, need be removed before the death can be linked to SIDS (Acton, 2012). A POSSIBLE SIDS should be examined through the inclusion of a full scene of death assessment and a full post-mortem should also be done, followed by radiographic emaciated investigation (Byard & Byard, 2010). Death scene needs to include the temperature, the position in which the baby was lying, and any form of rigor mortis.    

Management Plan     

There is no diagnostic test for SIDS currently, however, SIDS diagnosis is reached particularly when the actual cause of death is not known after a death scene examination, or a post-mortem and an evaluation of clinical history (Byard & Byard, 2010). There is no actual medication for SSID, since the condition is only diagnosed after the death of an infant. However, it is advised to put children to sleep on their backs as opposed to sleeping on their bellies’, not sleeping in the same bed as the baby,  but in the same room with separate beds, put babies to sleep on slightly rough bedding materials, and avoid smoking while pregnant (Acton, 2012).  

References

Byard, R. W., & Byard, R. W. (2010). Sudden death in the young. Cambridge: Cambridge University Press.

Acton, Q. A. (2012). Sudden Infant Death Syndrome (SIDS): New insights for the healthcare professional : ScholarlyPaper.

Marx, J. A., Hockberger, R. S., Walls, R. M., Adams, J., & Rosen, P. (2010). Rosen's emergency medicine: Concepts and clinical practice. Philadelphia: Mosby/Elsevier.

Is Marijuana Safe As A Medicine?

Marijuana is a drug that is illegal in almost every state in the world except for a few in the United States which have legalized the drug to be used in medication prescriptions. A marijuana plant that in many cases has been used to treat some symptoms of diseases like cancer as well as relieving body pains. The drug has not yet been considered safe for human consumption by the food and drugs body in the United States therefore illegal to use the drug. The research question is whether the drug marijuana can be or is safe for human consumption as a medicine (Phillips, 150). The question is very important since it gives a guideline to whether the drug is really safe for human consumption or else whether the plant should be allowed to be grown in any state now that most states have marijuana as an illegal substance. The different perspectives which can be very useful in the research include why the drug is still been planted in the states and also the benefits and consequences of using the drug as a medicine at any particular point. Based on the different arguments presented in this research questions, one can identify diverse ideas on its usage as well as the objections of ever legalizing the drug.

According to research, there have not been an intensive research and laboratory tests which can term the drug as either safe or unsafe for human consumption. The potential capabilities of having the drug used for medication have been the most heated debates for many decades now. Marijuana in some cases has presented practical benefits when it comes to relieving pain on some subjects (MacCoun and Michelle, 991). This, however, is not a confirmed incident since the drug has also among many disadvantages which can be fatal. However, the food and drugs body has already approved some use of marijuana for example in treating nausea where Marinol is used and has contents of marijuana. In the past, nausea used to be a condition that affected almost 80 percent of Americans making it a common condition and which is dangerous at any level. Researchers have identified the drug to contain some harmful component which when used by humans can cause addiction (Hurd, 125). Addiction is one of the many disadvantages of using the drug.

In the world today millions of people and especially the youths have been affected by this addiction that has left many people dead and others with serious body complications. The drug when regulated has many benefits but it is a dangerous move to use the drug. In some cases, those who have pushed for the drug to be legalized are influential people who have an interest in terms of making the largest sales of marijuana to the appointed health care centers but without the concern for the general public who will use the drug (Schauer et al., 4). Marijuana has been known to be the root cause of many complications in the society today. Many streets, especially in the United States, are affected by the drug. Laws have been formulated to prevent more people from using the drug or even handling the drug. To this argument, it means that there is a serious reason as to why the drug is not been legalized in such platforms. If the responsible authorities and the states have possible reasons to prosecute anyone found with the drug, why should it be used in medication and it is the same drug? It is a serious issue based on whether the research is biased or it is the actual and correct thing to do with the drug (MacCoun and Michelle, 989).

The United States is known for having the best when it comes to medical examinations and therefore having the research as inconclusive is a difficult ideology to understand. It has been over 10 years since the drug started being tested if it was harmful for human consumption but until today, there are no outcomes of the report only that some researchers are persistently combining the contents of marijuana with other drugs to come up with a drug that can treat some of these diseases which are generally affecting a common man. Patients with HIV/Aids also are recommended to use the drug especially due to the wasting syndrome caused by Aids (Hurd, 124). There are some several medications which have allowed the use of marijuana contents but many medications are still testing for the side effects of using the drug to cure some diseases. For example, in Canada and the United Kingdom, there is a mouth spray that is used in curing pains such as neuropathic and spasticity and which accompany much sclerosis which may contain the contents of marijuana (MacCoun and Michelle, 990). In the United States, marijuana as medicine is being tested to determine whether it can be used to cure some epilepsy found in children. Marijuana use as a medical piece is a disastrous idea since the users are not aware of the side effects of using the drug. Addiction is currently affecting many people and if the drug is used for medication, then there is no doubt that the addiction problem will persistently increase drastically.

Works cited

Hurd, Yasmin L. "Cannabidiol: Swinging the marijuana pendulum from ‘weed’to medication to treat the opioid epidemic." Trends in Neurosciences40.3 (2017): 124-127.

MacCoun, Robert J., and Michelle M. Mello. "Half-baked—the retail promotion of marijuana edibles." New England Journal of Medicine 372.11 (2015): 989-991.

Phillips, Jennan A., et al. "Marijuana in the workplace: Guidance for occupational health professionals and employers: Joint guidance statement of the American Association of Occupational Health Nurses and the American College of Occupational and Environmental Medicine." Workplace health & safety 63.4 (2015): 139-164.

Rezkalla, Shereif, and Robert A. Kloner. "Recreational marijuana use: is it safe for your patient?." (2014): e000904.

Schauer, Gillian L., et al. "Toking, vaping, and eating for health or fun: marijuana use patterns in adults, US, 2014." American journal of preventive medicine 50.1 (2016): 1-8.

Turnbull, David, and James G. Hodge Jr. "Driving Under the Influence of Marijuana Laws and the Public's Health: Public Health and the Law." The Journal of Law, Medicine & Ethics 45.2 (2017): 280-283.

Policy Analysis

The Affordable Care Act 

 The Affordable Care Act was ratified in 2010 for the purpose of improving health care services, expanding insurance accessibility, expansion of health workforce, minimizing the health care costs, and protecting consumers. In ensuring the achievement of the initiatives, the State played the role of developing and implementing health insurance and expansion of Medicaid program. Since its enactment in 2010, ACA’s provision was effective in 2014 and by 2016; 20-24 million people were covered by insurance. This was influenced by expansion of Medicaid program and remarkable changes in insurance markets. The provision led to deliver system reforms which decreased the healthcare spending and budget deficit, and improved quality care. Since 2010, the number of insurers has been decreased by 17.6million and majority of people aged 65 years and below can now access quality care through the help of health insurance.

 The ACA law was aimed at reforming the health care and artcle by Fitgerald, Bias & Gurley-Calvez (2017) states that the law has played a fundamental role in consumer well-being.  The effort to improve health care started back in 1993 when President Clinton implemented a healthcare reform which aimed at bringing universal healthcare. Indeed, various policies for controlling Medicaid and Medicare cost have been implemented. ACA aimed at progressing with these reforms and came up with the goals of improving quality care, minimizing health care cost, increasing health care access and consumer protection (Fitzgerald, Bias & Gurley-Calvez, 2017).  Note that in 2011, the health care cost per capital was &8,508 in U.S and it was ranked last due to its failure to manage infant mortality and life expectancy. In addition, the country was characterized by teen pregnancies, disability, sexually transmitted diseases, obesity among other illnesses. U.S also faced financial challenges which hindered access to quality care. However, the enactment of ACA law led to remarkable changes as it aimed at eliminating out-of-pocket and increasing preventive services, improving Medicare, developing price transparent for medical services, provision of tax credits to small business and middle-class families.  ACA also improved accessibility through increasing health insurance marketplace for affordability and quality (Fitzgerald, Bias & Gurley-Calvez, 2017).  There was Medicaid expansion which covered the working poor and disabled individuals. Rural providers of health care benefited from reimbursement and this motivated them in offering quality services in rural communities thereby improving accessibility.

 Prior to the enactment of ACA, majority of people in America could not afford quality health care due to higher cost. However, Americans were interested in bringing change on issues regarding the high cost of health care and lack of insurance coverage which increased medical debt. These issues have been dealt with since the passage of ACA and it has increased the affordability to all Americans and the number of uninsured is reduced (Custer, 2017). Since 2010, only few percent of American report lack quality care for financial matter.  Medicaid expansion has played an important role in minimizing financial burdens especially in low-income Americans. ACA led to insurance options and insurers can now take health coverage in either private or public sphere. In analyzing the policy, Custer (2017) asserts that ACA was enacted with a purpose of increasing competition on cost and quality among health insurers.  Health insurers were provided with individual subsidy, a reinsurance program, a risk corridor and a risk adjustment (Custer, 2017). All these protections were aimed at minimizing risk in individual market. ACA benefits on marketplace were influenced by Medicare program which   focused on risk adjustment.  Medicare program allows insurers to plan a favorable risk selection and implement several choices of providers.

 Prior to the passage of ACA, health care disparity was an issue of concern and policymakers increased attention in addressing the issue. There was disparity in insurance coverage and effort to address this problem was aimed offering quality health care insurance and minimizing medical cost. Majority of middle- and low-income workers where the large population was Blacks experienced disparities in health care (Mitchell, 2015). However, ACA decreased the uninsured rate especially in Black and Hispanic population. ACA has managed to bring this change because it focused on expanding Medicaid and ensure that the uninsured 50million individuals will receive insurance coverage. Prior to the passage of ACA, Medicaid was used to cover low-income families but nonelderly parents were not eligible for the coverage (Mitchell, 2015). ACA brought development by providing states with federal funding which supported families which were below the federal poverty level. ACA also provided private coverage where young people aged 19-25 years gained the coverage. There was  insurance market reforms  which diminished higher premiums  and developed  benefits package  and  health insurance for marketplaces which allows individual to have options on  coverage  choices.  Individuals who failed to pay insurance were penalized and employers who failed to pay for their employees were also penalized (Mitchell, 2015).  .

The ACA policy has become a debatable issue since the Republican administration   is not satisfied with ACA provision. The administration opts to repeal and replace but supporters argue that repealing will eliminate all the coverage gains which are provided by ACA (Willison & Singer, 2017). Republicans perceive the issue through the consumer-driven approach and a decentralized approach to allow the consumers and states to have authority over insurance choices and healthcare markets. They also believe that the repeal will decrease the federal spending by $90.9 billion and $927 billion by year 2021 and 2026 respectively (Willison & Singer, 2017). On the other hand, democratic argue that the number of uninsured will increase by 81% and the population which will be affected will be the working families, young adults and non-Hispanic whites. Given that the goal of ACA was to improve healthcare through various process including provision of tax credit, repealing will eliminate this provision.  Low-income families will suffer due to lack of quality care (Willison & Singer, 2017).In addition; the number of individuals who enroll in Medicaid will decrease. Medicaid and marketplace enrollment will decrease and the 56.6 million enrollees with reduce to 14.5 million enrollees.

 Recommendations

  Noticeably, there are remarkable accomplishments from ACA. It has improved the health care by ensuring that 10millions American has insurance coverage.  However, there is a political opposition which has brought controversy on ACA (Willison & Singer, 2017). The recommendation in addressing the issues facing ACA is that instead or repealing and replacing, there should be a process of fixing the flaws. First, a big fix should be on the area of insurance markets. The federal government should increase the cost-sharing reduction for consumer to compensate co-pays and deductibles.  Second, the federal government should   increase the subsidies   in the markets. To eliminate the out-of-pocket costs, there should refundable tax credit, expand the Medicaid and allow individuals to have an option between government and private insurance plans (Willison & Singer, 2017). Other Americans are experiencing challenges brought by cost sharing especially the employer-based plans. ACA should address this challenge by providing protection to the middle-income Americans. Finally, the system should be designed to empower citizens and allow them to decide on high-value services in order to live productive life (Willison & Singer, 2017).

Reference

Fitzgerald, M. P., Bias, T. K., & Gurley-Calvez, T. (2017). The Affordable Care Act and Consumer Well-

Being: Knowns and Unknowns. Journal Of Consumer Affairs, 51(1), 27-53.

doi:10.1111/joca.12059

Custer, W. S. (2017). Medicare Advantage as a Model for Affordable Care Act Marketplaces. Journal Of

Financial Service Professionals, 71(1), 40-42.

Willison, C. E., & Singer, P. M. (2017). Repealing the Affordable Care Act Essential Health Benefits:

Threats and Obstacles. American Journal Of Public Health, 107(8), 1225-1226.

Mitchell, F. M. (2015). Racial and Ethnic Health Disparities in an Era of Health Care Reform. Health &

Social Work, 40(3), e66-e74. doi:10.1093/hsw/hlv038

Diabetes

Diabetes insipidus is mainly caused by the abnormality in the levels or the functioning of the antidiuretic hormones (ADH) which are also known as the vasopressin. This hormone is manufactured in the hypothalamus and is stored specifically in the pituitary gland and it helps in the regulation of the amount of fluid located in the body (Zaccardi et al., 2016). Diabetes mellitus is basically a systemic kind of disease which is characterized by an increased level of sugars within the blood. The glycemic controls are not very crucial to the critically ill patients. Diabetes insipidus is characterized by the incapability of the kidneys to conserve the water and it is a rare complication.

In the insipidus type of diabetes, a patient gets very thirsty and the urine is much diluted compared to a normal person’s urine. Mellitus patients have their sugars high and at the same time their level of urinating is excessively high with an increased thirst most of the times. Diabetes insipidus is mainly caused by the effects of the having a low level of ADH. Brain tumor, injuries to the head and excessive medications can lead to this kind of diabetes (Mendez et al., 2016). Mellitus is caused by the genetics and also the kind of lifestyle a person is living or through a minor infection.

Genetics plays a vital role in diabetes. Diabetes can be highly dependent on the possibility of the parent and or siblings having diabetes. If both parents have diabetes then the risk of being diagnosed with diabetes is high and so the treatment will be of a lifetime.  Diabetes affects a person at any age the difference is the causes and the treatment (Mendez et al., 2016). The older people are most affected by this disease and therefore the diagnosis is done timely through testing the blood capacity levels for insipidus diabetes while for mellitus it is the plasma levels. Mellitus can never be cured but for insipidus, can be cured through desmopressin.

References

American Diabetes Association. (2014). Diagnosis and classification of diabetes mellitus. Diabetes care, 37(Supplement 1), S81-S90.

Mendez, C. E., Mesropian, P. J., Mathew, R. O., Slawski, B., Zhu, Y., Zhang, C., ... & Vilsbøll, T. (2016). Wolfram syndrome is a rare genetic disorder characterized by juvenile-onset diabetes mellitus, diabetes insipidus, optic nerve atrophy, hearing loss, and neurodegeneration. Although there are currently no effective treatments that can delay or reverse the progression of Wolfram syndrome, the use of careful clinical monitoring and supportive care can help relieve the suffering of patients and improve... Current Diabetes Reports, 16(1), 1-12.

Zaccardi, F., Webb, D. R., Yates, T., & Davies, M. J. (2016). Pathophysiology of type 1 and type 2 diabetes mellitus: a 90-year perspective. Postgraduate medical journal, 92(1084), 63-69.

Opioids

The drug you believe is most detrimental

Opioids are some drugs that are used in the relieving of pain and which if not well monitored can cause a person to become an addict of the drugs in due time. They can include the hydrocodone, morphine, oxycodone and many other types which fall under the opioid drugs. The opioid used as pain relievers are very safe when they are taken for shorter time according to the doctor’s prescriptions but since they develop some conditions of euphoria in relation to the pain relief, they are prone to been misused such as being taken anytime without the doctor’s advice and also taken just for fun (Chen et al., 2014). If they are taken very regularly even if the doctor advised on the drug they can be harmful to the users. Incidences of overdose and deaths are the most outcomes of these drugs.

In the case a person has overdosed on the opioids, a drug by the name naloxone can be used to reverse the situation if taken in the right quantity according to recommendations. In the states where the drug abuse level has gown drastically, the addicts have found a simple and healthy way of dealing with the addiction levels. From the year 2007, United States has been facing the challenge of drug abuse and thee has been an increase in the number of people who are dying as a result of the abuse (Nikoo et al., 2016). However, there has been an increased research for the medication availability for these deaths and medicines have been manufactured such as the naltrexone and methadone. These two examples of medicines could assist in making many people recover from the addiction of opioids.

Heroin among many opioids is the most addictive and also an illegal drug in many states. The rug is used by an increased number of millions of people around the United States and in the world. The users are much pressured to use this drug and they are unable to stop the urge to use it daily since most of them have the knowledge that the withdrawal signs of heroin are dangerous and hurting.  Heroin is obtained from the resin of the plants known as the poppy plants. The opium obtained is used in making the morphine and then later made into some forms of heroin. Most of the heroin is used by the drug users through the injection method which is an added risk for the users who can be infected with Aids or any other infectious disease which can contract through sharing needles to inject each other (Rudd et al., 2016). In the early 1850s, the addiction of opium was the biggest problem all over the United States and in Germany. The recommended solution for this problem was to have the addicts given another less non-addictive substance by the name morphine. The substitute, morphine, became another very big problem when it was proved to be more addictive than the opium.

Due to morphine being a very addictive drug compared to the opium, another drug was manufactured to reduce the effects of the drug. The drug that was supposedly manufactured as a non-addictive drug proved to be more addictive than the morphine. The drug was heroin. Heroin became more addictive than all the other drugs supposedly to be nonaddictive. A drug by the name methadone was developed to assist the people with addiction. In the United States, methadone was named dolphins in the 1940s (Chen et al., 2014). Dolophine was widely used to treat those affected by the addiction of heroin. Dolophine also became more addictive than the heroin. In the 90s, heroin addicts had a mortality rate of more than twenty times bigger than the whole population.

Why you believe the drug is most detrimental

Addiction to opioids has increased gradually over the years. This addiction in the world is the worst and at a high level that affects the social, economic and the health welfare of the general society. In the world today, between 27 million and 36 million people abuse the drug with more than 3 million people all around the United States seriously suffering from the disorders of the related drugs which are as a result of the prescriptions in the year 2012. More than 400 000 people are estimated to be addicted to heroin as opioids (Chen et al., 2014). Over the years, the consequences of the drug abuse have been on the rise and the resulting outcomes have been deaths. Those people who are dying from the prescribed drug overdose have increased and still on the rise in the United States. Prescriptions opioid is one of the many categories of the medications that have been prescribed and which present a liability in terms of abuse followed by stimulants and the central nervous system medications. Several factors may have contributed to the opioids being the most abused prescribed drugs in the world today. This is caused by the drastic increase in terms of the number of the prescriptions written and also dispensed.

Aggressive marketing of the drugs by the pharmaceuticals has increased the problem of addiction to the opioids (Nikoo et al., 2016). The above factors and many others have assisted in increasing the environmental availability of the prescription for the drugs and in particular the opioid related drugs. Currently, the death rate of people affected by the overdose from heroin and any other type of opioid is more than 30 000 people annually and this rate has influenced the world to call for a solution to this menace. This kind of epidemic did not take place over one night. Over the past decades, the problem has grown significantly thereby destroying the lives of many people all over the United States regardless of the age, wealth, location or race of the user.

A proposed prevention plan to reduce future use

The epidemic of opioid has affected and devastated millions of people and the community in general in the United States and therefore causing more than 300 000 deaths out of an overdose. The epidemic of opioids never started with the drug related industry wanting to sell huge volumes of drugs or the prescribers recommending recklessly (Kolodny et al., 2015). It all began with the doctors who were compassionate enough to look for a solution to the humans suffering from various complications. Painkillers over the world have been used to reduce the effects of some complications. Such painkillers include the Percocet, Vicodin and many others have caused millions of people to suffer from a drug overdose. Heroin use has drastically increased around the world making it a big issue for the world to deal with the issue with finality.

Opiates were used in large quantities in the 90s but by then they were legal and has made it comfortable for everyone to use them but the government conducted a crackdown which leads to the drug being hard to get (Rudd et al., 2016).  Educating the patients and the physicians on the safe methods of prescribing the opioids can help reduce any addiction levels in the future. Universal precaution of the pain medications needs to be implemented to help reduce any possibilities of having patients affected by the drugs. This methodology will help in making sure that the patients use only the recommended and which have no adverse effects on human life.

Programs which will help in the monitoring the use of the prescribed drugs and the number of pharmaceuticals which have been licensed to deal with prescribing the drugs will assist in ensuring there is control over the use of the drugs. Having the family members and the general society live a healthy and comfortable lifestyle will help improve the state of the affected person’s in the future.  The inappropriate prescription is also very important to consider in order minimizing the use of the opioids. Medical errors, wrong selection of patients, incorrect directions and prescribing the wrong opioids is very important to monitor. Developing algorithms which can be used in the identification of mismatches is also very important (Califf et al., 2016).

Electronically prescribing, use of prescribing officers and direct monitoring will promote safe opioids intake in the future and also increase the accuracy of issuing medical prescriptions to patients in the future. Referring all the patients who have pain issues to specialists who have the capability and the knowledge of prescribing correctly is very important (Kolodny et al., 2015). The addicted patients can be educated and also encouraged with other duties which will help them recover from the addictions is important. Involving the addicts in activities that will help them see the value of not using heroin and any other opioids is crucial in the future.

References       

Califf, R. M., Woodcock, J., & Ostroff, S. (2016). A proactive response to prescription opioid abuse. New England Journal of Medicine, 374(15), 1480-1485.

Chen, L. H., Hedegaard, H., & Warner, M. (2014). Drug-poisoning deaths involving opioid analgesics: United States, 1999-2011. NCHS data brief, (166), 1-8.

Hser, Y. I., Evans, E., Grella, C., Ling, W., & Anglin, D. (2015). Long-term course of opioid addiction. Harvard review of psychiatry, 23(2), 76-89.

Kolodny, A., Courtwright, D. T., Hwang, C. S., Kreiner, P., Eadie, J. L., Clark, T. W., & Alexander, G. C. (2015). The prescription opioid and heroin crisis: a public health approach to an epidemic of addiction. Annual review of public health, 36, 559-574.

Nikoo, M., Nikoo, N., Javid, S., Amiri, A., Vogel, M., Choi, F., ... & Schütz, C. (2016). Tincture of opium for treating opioid dependence: a systematic review of safety and efficacy. Addiction.

Rudd, R. A., Aleshire, N., Zibbell, J. E., & Matthew Gladden, R. (2016). Increases in drug and opioid overdose deaths—United States, 2000–2014. American Journal of Transplantation, 16(4), 1323-1327.