Please read the narrative below.  Use the suggested websites to familiarize yourself with the theory of evolution.  Use what you have learned about evolution in your reflection next week on chapters 1 & 2 of the Etcoff text, be sure to refer to material from at least 2 of the websites suggested below (be sure to clearly cite the websites you visited to ensure you get credit).  Post your reflections and by Wednesday, February 2, and reply to another student’s post by Sunday the 6th.

 

For this week’s post:  Your posts on last week’s material (Self-introductions and responses to the several questions I raised in the course material) are due by 11:59 pm Wednesday, January 26, and responses to another student’s post by NOON Sunday January 30.

 

Evolution and Darwin

 

We begin the course by considering how biology can explain human development and interaction.  The main theme of the Etcoff text is that we are treated differently by others based on our appearance, and many of the differences in our responses to people who are “prettier” compared to those who are not can be explained based on the theory of evolution.  The Etcoff book is one of many recent publications in the area of evolutionary psychology – a field that seeks to understand human behavior in light of the evolutionary pressures our species has faced in the past. Next week, we will focus on evolutionary psychology and the related area of sociobiology.  This week, we will look at the theory of evolution itself and the person who presented the modern version of the theory, Charles Darwin. Darwin’s theory (evolution through natural and sexual selection) is the single most revolutionary idea of the past 200 years, with wide-spread implications in all areas of life, including the understanding of social behavior.

 

Evolution through Natural Selection:  The theory of evolution through natural selection, first suggested by Charles Darwin in 1854, argues that species change through a simple process of competition between individuals.  Darwin was attempting to understand a puzzle about the nature of living things on earth. The puzzle was that at the same time, living things on earth are amazingly diverse (millions and millions of different unique species of living things), while being amazingly similar (all mammals have roughly the same skeletal structure, the same internal organs, at a cellular level the cells of all living things look the same, and at a molecular level all life on earth has DNA composed of the same 4 nucleic bases – although Darwin had no knowledge of DNA and the later discovery of this mechanism of inheritance is one of the great supporting arguments for the validity of his theory).  How could so much diversity, and at the same time so much similarity, be explained? The only explanation generally accepted for much of western history was that of divine creation.  But why would a divine creator create so many distinct life forms?  Why millions of different types of bugs?  And why create them all so much the same?  A theory that had become increasingly popular over about a century or so before Darwin was a theory called Evolution.  The theory of evolution argued that the similarity between species could be explained if we assume that all life started as a single form that changed (or evolved) over time into all the different forms we see around us.  The problem with the theory of evolution before Darwin was that there was no viable mechanism that would explain why change would happen – why would one original species change into other species?  Darwin’s great contribution to science was the discovery of that mechanism of change. Darwin’s theory, known as “Natural Selection” (and a later modification called “Sexual Selection”) has revolutionized our understanding of life, and nothing in the study of living things (including human development) can be fully understood without a grounding in evolution.  You can learn about the history and impact of the theory of evolution and about the evidence supporting the theory here:  http://www.ucmp.berkeley.edu/history/evolution.html, and more specifically, you can learn about the history of the theory here: http://www.ucmp.berkeley.edu/history/evothought.html.

 

One of the important facts about the history of the theory of evolution is that it was not Charles Darwin who came up with the theory – as we will discuss in more detail next week, Darwin proposed a viable mechanism for evolution, but the theory had been around for a long time.  Here is a brief review of pre-Darwinian views on evolution:   http://sci.waikato.ac.nz/evolution/DevelopmentEvolThought.shtml.

 

For your post next week, please discuss what you learned from at least two of the websites above, along with summarizing and discussing the first two chapters of the Etcoff text.  Be sure to clearly cite your sources, your post should be detailed and in-depth enough to demonstrate that you have thoroughly read and thought about the chapters in the book and that you have read the course material above and visited some of the websites I have recommended.  Each week, your points for discussion board posts will be based in part on how thoroughly you discuss and summarize both the readings and the course material from the previous week.  Also please keep the minimum length requirement for posts in mind.

As we continue our discussions on the importance of CPT coding, please start to think about the following as well

As we continue our discussions on the importance of CPT coding, please start to think about the following as well:

  • What do modifiers mean?
  • When are they appropriate to use?

What would it be like to be a  young single teenage mother in the San Fernando (California) community?

What would it be like to be a  young single teenage mother in the San Fernando (California) community?

What resources are available for them?

The patient care problem used as long-term LVAD patient on dialysis who no longer qualifies for a heart transplant

The patient care problem used as long-term LVAD patient on dialysis who no longer qualifies for a heart transplant; insurance ran out; pt can’t go home due to infection; has been on transplant until more than 365 days; the patient is depressed and non-compliant at times; stuck in the hospital with nowhere to go; unstable; can’t be transferred to a lower level of care

Question: Explain how the organizational budgets would be impacted.

Discuss teamwork/collaboration observed in your clinical week

Discuss teamwork/collaboration observed in your clinical week. discuss how your observations will be incorporated into your practice.

What is the difference between theory-guided practice and evidence-based practice?

What is the difference between theory-guided practice and evidence-based practice? Please I need references.

CBCS practice test and completing a focused review

CBCS practice test and completing a focused review. Respond to the following questions in your reflection:

-Which section(s) of the practice test were you most comfortable with?
-Based on the content you have covered so far, which section(s) of the practice test do you need to improve on?
-Which section(s) of the practice test do you have questions about?
-What is your plan for building your knowledge in the necessary areas?

Create a concept map or decision flow chart of a differential diagnosis showing signs and symptoms in assessing and diagnosing of a patient with different types of osteoporosis

Create a concept map or decision flow chart of a differential diagnosis showing signs and symptoms in assessing and diagnosing a patient with different types of osteoporosis. The kindly read the case study below for the signs and symptoms.

 

Reference: https://www.scribd.com/document/514553698/Bruyere-Case79-001-010

 

Case Study:

PATIENT CASE

Patient’s chief complains

“I’ve had back pain now for more than 5 weeks and I can’t stand it anymore. I’ve tried extra- strength ibuprofen, naproxen, and acetaminophen, and I’ve visited a chiropractor, but I don’t get any long-term relief.”

History of Present Illness

Mrs. I.A. is a very pleasant 63-year-old white woman of slight stature who has been referred to an orthopedic specialist by her PCP. She has been experiencing insidious back pain for 5-6 weeks. OTC analgesics provide temporary relief, but the pain is otherwise constant and aggravated by activity. She denies any obvious acute injury to her back, although she reports that she had a case of the flu with a prolonged and severe cough approximately one month ago. She also reports a vertebral fracture approximately five years ago.

The patient has been an avid gardener for many years. Following the death of her husband 18 months ago, she has continued to live in her house and do all the household chores. Since her back pain began, she has been limited in her ability to do her household chores and gardening.

Past Medical History

The patient entered natural menopause at 52 years and has never used hormone replacement therapy. Currently, she has mild hot flashes and vaginal dryness. At age 58, she suffered a vertebral fracture at T10 by simply carrying a shopping bag. DEXA scans conducted at that time revealed the onset of osteoporosis. Her bone mass density T-scores at that time were: -3.33 lumbar spine, -2.24 right femoral neck, and -2.44 right radius. These scans represented a 6.1%, 6.9%, and 6.2% decrease in bone mass density in the previous 19 months in the lumbar spine, right femoral neck, and right radius, respectively. Her serum calcium concentration was low-normal at 8.5 mg/dL and serum alkaline phosphatase level was moderately increased at 290 IU/L. She was prescribed alendronate and a calcium supplement daily.

The patient was diagnosed with a seizure disorder at age 22 years and is currently well controlled with phenytoin. She has had asthma since childhood. Her current asthma medications include a bronchodilator that she uses when needed, a daily steroid inhaler, and an oral corticosteroid that she uses about four times per year for 3-6 weeks when symptoms worsen. She also takes a daily multivitamin tablet and has 1-2 dairy servings every day. She has noticed a slight reduction in height in recent years, but denies any significant changes in weight. She had an appendectomy at 11 years of age.

 

 

Family History

The patient has a positive family history of osteoporosis. Her older sister has experienced a hip fracture and her paternal aunt was diagnosed with an osteoporosis-related wrist fracture following a fall.

Her mother was diagnosed with breast cancer at age 56, but died from lung cancer at age 69. She also suffered from high blood pressure and “high blood sugar.” Her father died at age 54 from AMI. Her brother (age 65) has HTN and high cholesterol, and her younger sister (age 57) has no known medical problems.

Social History

The patient smokes four cigarettes a day (down from 11⁄2 ppd eight years ago) and drinks one glass of wine daily. Her main sources of dietary calcium are milk with her breakfast cereal and “some” cheese about three times a week. The patient is widowed and was married for 39 years until the death of her husband 11⁄2 years ago. She has one son who is healthy. She had a miscarriage at age 19. She does most of her cooking and “watches what she eats.” She denies non-compliance with her medications. She gets very little weight-bearing exercise. She uses SPF 30 sunscreen to protect herself from sunburn and skin cancer every time that she spends more than 15 minutes in the sun.

Review of Systems

The patient denies any unusual bleeding, weakness, back spasms, shortness of breath, chest pain, fever, chills, heat or cold intolerance, and changes in her hair, skin, and nails. She reports vaginal dryness, occasional hot flashes and night sweats “maybe once every 6 months.”

 

Medications

• Alendronate 10 mg po QD

• Calcium carbonate 1.25 g (500 mg calcium) po BID

• Multivitamin tablet po QD

• Phenytoin 100 mg po TID

•  Albuterol MDI 2 puffs BID PRN

• Triamcinolone MDI 2 puffs QID

• Prednisolone 5 mg po BID PRN

 

Allergies

• Codeine intolerance (nausea, vomiting)

• Sulfa drugs (rash)

• Aspirin (hives, wheezing)

• Cats (wheezing)

 

Physical Examination and Laboratory Test

General

The patient is an alert and oriented, cooperative 63-year-old white female of slight stature who walks with a normal gait and is in no apparent distress. She appears somewhat anxious.

VS

  • BP-129/83 sitting, left arm
  • RR-20 and unlabored
  • HT-5 31⁄2″
  • PR-88 and regular
  • T-98.6°F oral
  • WT-106 lbs
Skin
  • Fair complexion
  • Color and turgor good
  • No lesions
Head
  • Normocephalic

Doorway Information

Doorway Information
Situation: Mary Chen is a 42-year-old department manager and she presents today to confirm an at-home pregnancy test.
Background: Mary and her spouse quit using birth control about eight years ago, in the hopes of starting a family. Initially,
she became pregnant after a few months of trying, but she had a stillbirth at 21 weeks. The patient states that they never
figured out what happened. They tried for another year and she became pregnant again but had a miscarriage at 10 weeks.
They continued to try and after going through a few simple tests and treatments without results, they decided to move on.
Mary realized it has been more than 6 weeks since her last period, so she tried a home pregnancy test a few days ago. It
came out positive.

Assessment: Mary is well-developed and well-nourished. She is anxious about the pregnancy test results.
Recommendation: The urine hCG was ordered, collected, and the results are pending. You are asked to check her weight
and vital signs, as well as take a thorough history and report the findi

Description of relevant health systems/public health systems for Ghana (West Africa) that are responding to the challenges of Chronic Kidney Disease (CKD) including how these challenges are targeted, to which population, who implements the action, and published evidence for efficacy or support a lack of evidence

Description of relevant health systems/public health systems for Ghana (West Africa) that are responding to the challenges of Chronic Kidney Disease (CKD) including how these challenges are targeted, to which population, who implements the action, and published evidence for efficacy or support a lack of evidence.

** Description of at least one example of a public health policy or program that is not currently enacted in Ghana (West Africa) that its believe if enacted, would positively impact the health of population in Ghana including relevant cultural values and practices, and why this policy or program would have a positive impact on the health of this population.

** Description of potential challenges and barriers to implementing the proposed policy or program in Ghana (West Africa).