Mark Corson

By X. Kalesch. Gallaudet University.

The focus is not on predetermined monary obstructive disease: Isolation and being closed in buy 5mg provera free shipping menstrual symptoms vs pregnancy symptoms. Life patterns of people with chronic ob- on fixing the patient generic 5 mg provera with amex menopause weight, but rather is on part- structive pulmonary disease: Isolation and being closed in discount provera 2.5mg otc pregnancy hormone. Journal of Advanced Nursing, states, “The theory asserts that every person 47(3), in press. Symposium presentation at the International Council of Nurses 22nd versal process of expanding consciousness— Quadrennial Congress, Copenhagen, Denmark. Newman’s Theory of Health as Expanding Consciousness and Its Applications 233 Kiser-Larson, N. Evolution of the theory of health as doctoral thesis, University of Minnesota, Minneapolis. The process of health patterning in fam- Nursing Education, The nurse theorists: Portraits of excellence ilies with young children who have been repeatedly hospitalized. Unpublished doctoral thesis, University of New York: National League for Nursing Press. Pattern recognition as a nursing interven- Newman’s theory of health as expanding consciousness: A tion with adolescents convicted of murder. International Journal for Human Caring, toral thesis, University of Minnesota, Minneapolis. Health as expanding consciousness Web through a nursing partnership with adolescents convicted of site. Journal as expanding consciousness in research, theory, and practice of Gerontological Nursing, 12, 16–18. Health as expanding consciousness (2nd sciousness in research, theory, and practice. Newman’s theory of health as expanding ple with dementia living in a nursing home. King Introducing the Theorist Introducing the Theory Use of King’s Conceptual System and Theory Summary Introducing the Theorist nursing adults in hospitals. While working my way through college, I worked in a physician’s office as a My postsecondary education experiences included school nurse and as an occupational health nurse. John’s Hospital have always believed that as a teacher one must also School of Nursing in St. Louis, baccalaureate and be an excellent practitioner, so my experience as a master’s degrees in nursing from St. Louis Univer- teacher of nursing at undergraduate and graduate sity, and a doctor of education from Teachers levels included practice. Postdoc- sity, Chicago; the Ohio State University; and the toral study included work in advanced statistics, University of South Florida, advancing from assis- systems research, and computers. Continuing tant professor to full professor and now as profes- education is an ongoing process. The history, and philosophy with emphasis on science most recent are the Jessie Scott Award for Leader- and ethics. The University of Tampa (Society) Department of Nursing named the annual research award given to students the “Imogene M. I also appear in Who’s (Individuals) Who in America, American Women, and Who’s Who in Nursing. Introducing the Theory Continuous discoveries in telecommunications and technology, and a daily bombardment of infor- mation about world events bring complexity to one’s life that is unprecedented in history. As in- process for developing a conceptual system is dividuals, we are born, grow, and develop within explained. A goal attainment from my conceptual system is sense of a global community can be understood as demonstrated. The application of this conceptual we view the interactions of individuals and groups system and Theory of Goal Attainment is discussed with linguistic, ethnic, and religious differences. My first theory publication pronounced the prob- The commonality in my worldview is human lems and prospect of knowledge development in beings who communicate and interact in their nursing (King, 1964). Over 30 years ago, the prob- small groups within their nations’ social systems; lems were identified as (1) lack of a professional that is, human environments as well as physical en- nursing language; (2) atheoretical nursing phe- vironments. Concept development is a continuous represent interconnected links for information pro- process in the nursing science movement (King, cessing in a high-tech world of health care and 1988). This conceptual system provides one ap- My rationale for developing a schematic repre- proach to structure a world community of human sentation of nursing phenomena was influenced beings, who are the recipients of nursing care. King’s Theory of Goal Attainment 237 interaction in those works influenced my ideas rel- framework”), and the result was the publication of ative to organizing a conceptual frame of reference a book entitled Toward a Theory of Nursing (King, for nursing, as shown in Figure 16–1. From being, commonly referred to as an “individual” or a my initial set of ideas in 1968 and 1971, my con- “person. For example, the concept of ings (ontology) and to the nature of knowledge perception has been studied in psychology for (epistemology). The literature indicated that most of the early studies dealt with sensory perception. From this research literature, I in systems research, I was introduced to a philoso- identified the characteristics of perception and de- phy of science called General System Theory (Von fined the concept for my framework. This philosophy of science searching literature for knowledge of each of the gained momentum in the 1950s, although its roots concepts in my framework. Von Bertalanffy, credited “Searching for scientific knowledge in nursing is an with originating the idea of General System ongoing dynamic process of continuous identifica- Theory, defined this philosophy of science move- tion, development, and validation of relevant con- ment as a “general science of wholeness: systems of cepts” (King, 1975). A concept is elements in mutual interaction” (Von Bertalanffy, an organization of reference points. This philosophy different types according to the different sources of gave me the impetus to focus on knowledge their meaning....

Isopropyl alcohol is applied to the hands purchase provera 10mg without a prescription menstrual 9gag, which are then blotted dry with paper or cloth towels provera 5 mg women's health clinic balcatta. Another technique involves using a hair dryer to dry the skin by setting the hair dryer on low heat and blow drying the hands buy 5mg provera visa women's health clinic taos nm. Te fnal method, called the fame technique, involves the use of a butane grill lighter to dry the skin. Te fame is moved back and forth across the friction skin for a few seconds, taking care to dry but not to char the skin. Te same results can be accomplished by roll- ing a fnger over a hot light bulb instead of using an open fame. Since the early days of fngerprinting, the standard method for record- ing fngerprints has been the application of a thin layer of black printer’s ink to the fngers and then recording the friction ridge impressions onto a fngerprint card. Although this technique works well with the living, it is more difcult in its application for printing the dead. Te examination of a body usually takes place with the deceased positioned on his or her back for eventual autopsy. Tis position makes it difcult or nearly impossible for the examiner to apply ink to the fngers using an inking plate, and thus requires that ink be rolled onto a spatula and applied to the fngers. Te application of too much ink may result in distorting/smudging of the recorded prints. It is also not feasible to roll the fnger impressions onto a fngerprint card, espe- cially when rigor mortis has set in the body. Te recording of inked impres- sions is thus accomplished using a tool called a spoon that can be placed on the end of the fnger. Fingerprint blocks are held in the spoon and are used to capture friction ridge detail and create a complete fngerprint record. Te recommended recording strategy for recovering fngerprint impres- sions from deceased individuals involves the use of black powder and white adhesive lifers. Tis technique is quick and easy to use, resulting in clear prints compared with those obtained through inking. Te frst step in the procedure is to lightly coat the fngers with black powder, covering the entire pattern area, using a traditional squirrel hair fngerprint brush or sponge-type paintbrush. Te lifer is placed just below the frst joint and then wrapped around the fngertip to record the powder impression. If debris from the fnger is being lifed along with the powder and obscures ridge detail, a less adhesive lifer, such as a mail label, should be used. Te recorded impression is then afxed to the back of an acetate fngerprint card (Figure 6. Tis type of clear plastic card can be produced by photo- copying a standard fngerprint card onto transparency flm. Some alternative printing strategies that are useful in recording quality postmortem impressions from difcult remains involve the use of Mikrosil® (Kjell Carlsson Innovation, Sundbyberg, Sweden) and AccuTrans® (Ultronics, 96 Forensic dentistry A B Figure 6. Mikrosil is a casting putty that was originally developed for toolmark examinations before being used in the fngerprint discipline to recover latent impressions from irregular surfaces. AccuTrans is a relatively new polyvinylsiloxaine casting agent specifcally designed for the recovery of latent fngerprints and other forensic evidence. Both products have also been used as a way of recording friction ridge impressions from the living and the dead. Te casting technique works exceptionally well on desiccated remains containing wrinkles in the friction skin. Tis technique can be used afer the fngers have been rehydrated or at a disaster scene when rehydration is not an option and fngerprints need to be recovered from remains without delay. Te frst step is to lightly coat the fngers with black powder, followed by the application of Mikrosil or AccuTrans, which is white in color, to the fngers. Mikrosil must frst be mixed and then applied to the fngers with a spatula, whereas AccuTrans comes with an automix gun option that allows direct application to the fngers. Te casting material must be allowed to dry on the fngers before being peeled of to capture the print (Figure 6. Recovered prints will be in correct position and color when compared to an antemortem standard. When all described recording techniques have failed to produce quality postmortem impressions, images of the friction ridge detail present on the fngers can be captured with digital photography. Te proper selection of direct, oblique, refected, or transmitted lighting schemes will enhance the appearance of ridge detail, ofen resulting in quality images that can be used for identifcation purposes. It is also important to capture 1:1 images of the friction skin because the photographs will be compared with antemortem impressions of natural size. If this cannot be accomplished, a scale or object of a known size should be included in the photograph so that image dimensions can be corrected through the use of digital imaging sofware. Te expe- ditious identifcation of postmortem remains depends on the most important technological advancement in the history of fngerprinting: the Automated Fingerprint Identifcation System. Some of the most important criteria in using fngerprints as a means of human identifcation is the cost-efective and rapid reporting of results, which is directly related to fngerprint computer technology. Te postmortem prints then can be compared manually to the antemortem record to verify identity. Te records can be obtained and manually compared with recovered post- mortem impressions, depending on the number of fatalities.

It varies in severity from a mild illness caus- ing a rash or joint pains discount 10mg provera otc menopause goddess blog, to a life-threatening multisystem illness 5mg provera menopause doctors. Glomerulonephritis is another common manifestation of lupus and may present with microscopic haematuria/proteinuria generic 5mg provera overnight delivery womens health haverhill, nephrotic syndrome or renal failure. Arthritis commonly affects the proximal interphalangeal and metacarpophalangeal joints and wrists, usually as arthralgia without any deformity. Differential diagnosis of the combination of headaches/psychiatric features/fits • Meningitis/encephalitis • ‘Recreational’ drug abuse, e. A renal biopsy will provide histo- logical evidence of the severity of the lupus nephritis. As soon as active infection has been excluded, treatment should be started with intravenous steroids and cytotoxic agents such as cyclophosphamide. There are also lymph nodes 1–2 cm in diameter, palpable in both axillae and inguinal areas. On abdominal examination, there is a mass palpable 3 cm below the left costal margin. Persistent lymphadenopathy and con- stitutional symptoms suggest a likely diagnosis of lymphoma or chronic leukaemia. Repeated minor trauma and infection may cause enlargement of the locally draining lymph nodes. Enlargement of the left supraclavicular nodes may be due to metastatic spread from bronchial and nasopharyngeal carcinomas or from gastric carcinomas (Virchow’s node). However, when there is generalized lymphadenopathy with or without splenomegaly, a sys- temic illness is most likely. The typical systemic symptoms of lymphoma are malaise, fever, night sweats, pruritus, weight loss, anorexia and fatigue. Severe skin itching is a feature of some cases of lymphoma and other myeloproliferative illnesses. Radiotherapy alone is reserved for patients with limited disease, but this patient has wide- spread disease. He should be given allopurinol prior to starting chemotherapy, to prevent massive release of uric acid as a consequence of tumour lysis, which can cause acute renal failure. The pain has been colicky in nature and is associated with a feeling of distension in the left iliac fossa. Four years previously she passed some blood with her bowel motion and had a barium enema performed. Over the last week her pain has worsened and now she has continuous pain in the left iliac fossa and feels generally unwell. In her previous medical history she had a hysterec- tomy for fibroids 20 years ago. Colonic diverticula are small outpouchings which are most commonly found in the left colon. They are very common in the elderly Western popula- tion probably due to a deficiency in dietary fibre. Symptomatic diverticular disease has many of the features of irritable bowel syndrome. In severe cases, perforation, paracolic abscess formation or septi- caemia may develop. The barium enema from 4 years ago shows evidence of diverticular disease with outpouch- ings of the mucosa in the sigmoid colon. This would be consistent with the long-standing history of abdominal pain of colonic type and tendency to constipation. In her case there is no evidence of peritonitis which would signal a possible perforation of one of the diverticula. The differential diagnosis, with the suggestion of a mass and change in bowel habit, would be carcinoma of the colon and Crohn’s disease. In the absence of evidence of perforation with leak of bowel contents into the peritoneum (no peritonitis) or obstruction (normal bowel sounds, no general distension), treatment should be based on the presumptive diag- nosis of diverticulitis. A colonoscopy should be performed at a later date to exclude the possibility of a colonic neoplasm. Treatment should include broad-spectrum antibiotics, intra- venous fluids and rest. Further investigations are indicated, including electrolytes, urea and creatinine, glucose, liver function tests and blood cultures. Her blood pressure has been difficult to control and she is currently taking four agents (ben- drofluazide, atenolol, amlodipine and doxazosin). She had normal blood pressure and no pre-eclampsia during her only pregnancy 9 years previously. Risk factors for essential hypertension include a family history of hypertension, obesity and lack of exercise. She does not have paroxysmal symptoms of sweating, palpitations and anxiety to suggest a phaeochromocy- toma. There are no clinical features to suggest coarctation of the aorta (radiofemoral delay) or neurofibromatosis (café-au-lait spots/neurofibromas). Serum potassium is not low mak- ing Conn’s syndrome or Cushing’s syndrome unlikely. The principal abnormality is the modestly raised creatinine suggesting mildly impaired renal function. The absence of a renal bruit does not exclude the possibility of reno- vascular disease. This is common in elderly patients with evidence of generalized atherosclerosis (peripheral vascular disease and coronary artery disease). The commonest form is medial fibroplasia with thinning of the intima and media leading to formation of aneurysms alternating with stenoses, leading to the classic ‘string of beads’ appearances on angiography.

All of these drugs carry the risk of serious side effects so it is important to discuss the benefits versus risks with your doctor order 2.5 mg provera with mastercard womens health care associates jacksonville nc. Foods to avoid: • Alcohol can cause flare-ups and also decrease the effectiveness of treatments buy generic provera 5 mg on-line pregnancy 4 weeks. To determine if food sensitivities are triggering your psoriasis discount provera 5mg amex uc davis women's health center, try an elimination diet (see Appendix D). Add mineral or sea salts, bath oil (lavender), or oatmeal to the water and soak for at least 15 minutes. Use a heavy cream or an oint- ment as they will keep the skin hydrated longer than lotions. We produce a powerful form of vitamin D when our skin is exposed to sunlight and this vitamin D can improve skin lesions. When spending a longer time outdoors, apply a sunscreen to areas not affected with psoriasis to protect against sunburn. Top Recommended Supplements Fish oils: Contain beneficial fatty acids that help reduce inflammation. Some studies have found benefits with high doses of fish oils in improving skin lesions. Some research has also found benefits with applying fish oils (10 percent concentration) directly to the psoriatic lesions twice daily. Oregon grape: Contains compounds that slow the rate of abnormal cell growth and reduce inflammation. Several studies have shown benefits for reducing symptoms, but it does not appear to be as effective as prescription creams. Dosage: Apply a cream containing 10 per- cent Oregon grape extract three times daily to the affected areas. Complementary Supplements Aloe vera: Helps to reduce inflammation and has antibacterial and antifungal properties. For some, the sensations may feel as though insects are creeping on or in their legs. This restlessness may prevent them from sitting com- fortably for extended periods of time. It is R thought that it may be due to an imbalance of the brain chemical dopamine, which sends messages to control muscle movement. This may involve blood tests or a general examination regarding overall health, diet, lifestyle, and prescription drug use. To counter mild symptoms, a doctor may recommend lifestyle approaches as noted below, and, for severe cases, medication. There are four types of prescription medications that are used: Anticonvulsants, such as gabapentin (Neurontin) help ease the abnormal sensations. Dopaminergic drugs boost dopamine levels, which help central nervous system function. Muscle relaxants and sedatives help promote relaxation and sleep, but they also cause drowsiness the next day and are addictive. Minimize caffeine-containing products (including chocolate, coffee, tea, and soft drinks) for a few weeks to see if this helps. Aim for seven to nine hours of sleep per night and establish good sleep hygiene habits (make your bedroom quiet and comfortable, do relaxing activities in the evening, and go to bed and get up at the same time). Do not take iron supplements unless you have low iron levels (ask your doctor to check this) because too much iron can cause side effects. Multivitamin/mineral complex: Ensures that your body is getting all essential nutrients. Low levels of B-vitamins (especially B1, B6, B12, and folic acid) can impair muscle function and nerve health. Complementary Supplements Melatonin: A hormone that is naturally secreted by the brain in response to darkness and regulates sleep/wake cycles. Supplements reduce the time needed to fall asleep, reduce nighttime wakening, and improve sleep quality. Valerian: An herb that is widely used for insomnia; it improves many aspects of sleep and is non-addictive. Some formulas combine valerian with hops, passionflower, and other herbs that promote relaxation. Get regular exercise and avoid sitting for extended periods of time without stretch- ing. Rosacea is often mistakenly referred to as “adult acne” or “acne rosacea” be- cause it afflicts adults. While rosacea may resemble acne in that the outbreaks can come and go, triggered by a variety of lifestyle factors, unlike acne, rosacea outbreaks do not cause blackheads or whiteheads, and may often be accompanied by burning, stinging, or chapped, dry skin. Rosacea is also associated with several eye conditions, including swollen, burning, itchy eyes called ocular rosacea. Some estimates suggest that up to two million Canadians suffer from various degrees of rosacea. Since this condition has a traumatic impact on sufferers, it is critical to find ways to control the symptoms and reduce outbreaks. While rare, rhinophyma may cause large warty growths to appear around the nose, and the skin to take on a wax-like appearance. For more severe cases, antibiotic pills may be prescribed in combination with antibiotic creams. Azelaic acid cream is a new product available in Canada for the treatment of rosacea.