Category: Medicine and Health

• All text in Times New Roman 12 point font
• Separate title page and separate reference page
• Headers (page numbers)
• No less than 300 words (excluding the title, headers, and works cited)
• Double spaced lines & indent the beginning of each paragraph
• Works cited/Reference page with hanging indentions & in-text citations
Works Cited:
Last name , First name, Middle “ Article Title.” Journal Title (Year) : pages from – to or web address .
Works Cited example:
Nordhaus, William D. “After Kyoto: Alternative Mechanisms to Control Global Warming.”  American Economic Review, vol. 96, no.2, 2013, pp. 31-34.  www.JAMA.com (https://keiseruniversity.blackboard.com/webapps/blackboard/content/www.JAMA.com)
In-text citation example: (Nordhaus, 2013)

The topic for this essay is about saviour siblings. 
Provide a normative argument, meaning to argue in favour of a position. 
Please write an argument from the position of a designated decision-maker (DDM) from the following scenario. 
A child, Ethan, has been diagnosed with Wiskott –Aldrich syndrome. This is a life-threatening illness, and reduces his quality of life substantially. 
His elder brother, Jefrey, was cured via a marrow transplant from a younger brother, Charlie. Charlie is not a match for Ethan. 
His parents would like to have another child with the intention that it will be a saviour sibling for Ethan. 
In this essay, it is required to; 
Identify and apply major ethical theories and principles;
Apply skills of ethical reasoning and analysis to current issues in reproductive medicine and medical research;
Better understand and relate to your own moral commitments and decisions, in addition to those of others.
Please use Harvard referencing. 
It is part of a forum, below I have given an example of a response that has already been submitted to help with the task layout etc. 
“As a DDM considering this case, I have deemed it is ethical to allow the Thompson’s to use IVF with PGT to create a saviour sibling for their son Ethan. I have considered this decision from each persons’ perspective. 
Ethan:
Without the BMT, Ethan will have a chronic health issues including chronic eczema, frequent infections, an increased bleeding risk including easy bruising and internal bleeding. These health issues require frequent hospital visits and infusions and some of the complications from his condition can be life-threatening. With the BMT, Ethan will potentially be cured like his brother. The alternative of using an unmatched donor is an options, however, a sibling matched donor is superior in terms of the success of the BMT and lower risk of GVHD, thus a better outcome for Ethan. A saviour sibling may very well save his life. 
Parents:
Ultimately Ethan’s parents’ are autonomous individuals who are able to make informed decisions about their reproductive choices and the right to procreate.(1) IVF with PGT is expensive, invasive and has associated risks. They may also require multiple rounds in order to find a HLA compatible embryo that also does not carry the genetic condition WAS. Ethan’s parents want to do the absolute best thing for their child. Zeirhut et al’s paper was a descriptive analysis of parental experiences with PGT in of children with Fanconi anaemia (FA) and they found the health of the child was the most important factor in parents decision making process to undergo PGD. (2) Additionally, their findings demonstrated that parents who underwent PGD had little regret for the decision to do so, regardless of their IVF outcome. (2)
Saviour sibling:
Ultimately, proponents against saviour siblings will argue that the creation of a sibling for the purpose of a BMT diminishes the life of the saviour child. They will argue the child may come to physical and psychological harm from being a saviour sibling and could impact on relationships and the family dynamic. This does not consider the positives impact it may bring knowing that they were able to save their sibling’s life. Additionally, according to the non-identity principle, the saviour sibling would not exist if Ethan’s parents did not use IVF with PGT to create them. Thus, arguing of harm to the saviour child must be balanced against the alternative, which is non-existence. It is illogical to argue that non-existence is superior to being born to help save a sibling. This principle has been upheld in Australian high courts where children born with disabilities have no right to compensation for wrongful life.3  
Societal implications:
Having a readily available matched donor via a saviour sibling could lead to cure for Ethan. This would mean less of an economic burden on his family and on the healthcare system. Additionally, IVF with PGT would mean any children born to Ethan’s parents will not be affected by WAS and thus not have to undergo the pain and suffering of having a severe chronic health condition. 
Ultimately, as a DDM there are two options to consider.
1. Deny the IVF with PGT to create a saviour sibling for Ethan. This would lead to him to have ongoing chronic life-threatening health concerns and potentially a long wait for an unmatched donor for a BMT. If he is lucky to receive a BMT he is at a higher risk of failure and GVHD. This option leads to considerable pain and suffering for Ethan and his family and rejects his parents autonomy. 
2. Allow IVF for PGT to create a saviour sibling for Ethan. This is more than likely to lead to a cure for Ethan and it respects the autonomy and reproductive rights of his parents. Overall, the benefit of this outweighs the potential risks and harm to the saviour sibling. 
The morally and ethically right decision is to allow IVF for PGD to create a saviour sibling for Ethan.
1. Brake, Elizabeth and Joseph Millum, “Parenthood and Procreation”, The Stanford Encyclopedia of Philosophy (Spring 2022 Edition), Edward N. Zalta (ed.), URL = .
2. Zierhut, H., MacMillan, M. L., Wagner, J. E., & Bartels, D. M. (2013). More than 10 Years After the First ‘Savior Siblings’: Parental Experiences Surrounding Preimplantation Genetic Diagnosis. Journal of Genetic Counseling, 22(5), 594–602. https://doi.org/10.1007/s10897-013-9591-5
3. David Hirsch. (2006). Rights and Responsibilities in Wrongful Birth/Wrongful Life Cases. University of New South Wales Law Journal, 29(2), 233–238.”

Crimes of the Heart: A Case Study on Cardiac Anatomy
Tiffaney
is worried about her newborn son. Ever since she brought Caleb home
from the hospital it has been so hard to get him to eat and he seems to
be breathing too hard all the time. She stopped breast-feeding and tried
every bottle and formula on the market, but nothing has worked. So, at
his one-month check-up, her stomach is in knots as they place Caleb on
the scale. The nurse says, “9 pounds, 7 ounces.” Tiffaney realizes Caleb
has only gained one pound since he was born, and she breaks into tears.
Dr.
Baker checks over Caleb in the exam room, taking extra time feeling and
listening to his chest. During the exam, Tiffaney explains her struggle
with trying to get her son to eat and how he cries almost the entire
day. After the exam Dr. Baker says, “When I listen to Caleb’s heart, I
hear an extra sound called a murmur. I want to use an echocardiogram and
an ECG to get a good picture of all the parts of his heart.”
After
a full day of tests, Tiffaney meets with Dr. Baker in his office. He
explains, “After a careful review of all the information, I have
discovered that Caleb has a hole in the heart muscle wall between his
right and left ventricles. We call it a ventricular septal defect. That
is probably why he has been so irritable and hard to feed. The hole is
not very big, but he will still need to have surgery to repair it.”
Although the thought of her tiny son having surgery is terrifying,
Tiffaney is relieved to know why things have been so tough at home.
In your discussion post, you should include:
a) Main discussion paragraph (one or two paragraphs) and
b) Reply to at least TWO of your classmates. 
Important points to include in your Main discussion post.
Paragraph 1
Caleb has abnormal heart sounds that tipped the doctor off to a problem.
Name the normal sounds of the heart and indicate what causes these sounds.
In relation to the normal heart sounds, when would you expect to hear the abnormal sound Dr. Baker heard? Explain your answer.
Paragraph 2
Background.
Set the scene: background information, relevant facts, and the most
important issues. … (What made Tiffaney suspect that there was
something wrong with her infant?)
Evaluation
of the Case. Outline the various pieces of the case study that you are
focusing on. … (How did Dr. Baker proceed with her examination and
what were her conclusions?
____________________________________________________________
Reply to TWO of your classmates
– Your reply should include (Proposed Solution/Changes/recommendations.
… (What did Dr. Baker suggest? What are the benefits/risks of the
proposed heart surgery on an infant (exchange ideas/thoughts with TWO your classmates)
Respond to the following classmate post (1): Typically,
the heart generates two discernible sounds. Known as “lub-dub,” these
normal sounds accompany each heartbeat. The initial “lub” sound arises
from the closure of the mitral and tricuspid valves at the onset of
systole, while the subsequent “dub” sound is attributed to the closure
of the aortic and pulmonary valves at the conclusion of systole. These
acoustic signals serve as critical markers of robust cardiac function,
demonstrating the systematic circulation of blood within the heart. In
Caleb’s case, Dr. Baker identified an anomalous sound referred to as a
murmur during his examination. Murmurs arise from turbulent blood flow
within the heart’s chambers or valves. Dr. Baker detected this murmur
just after S1 and preceding S2, as blood traversed the ventricular
septal defect (VSD), producing distinctive acoustic qualities that
warranted additional investigation through echocardiography and
electrocardiography (ECG). Tiffany’s concerns surfaced shortly after
she returned home from the hospital and began caring for her newborn.
Observing her baby closely, she noticed signs such as feeding
difficulties, excessive irritability, and respiratory distress. In the
lead-up to Caleb’s one-month checkup, Tiffany diligently experimented
with different feeding methods, including discontinuing breastfeeding,
trying various bottles, and testing different baby formulas, hoping to
identify the cause of Caleb’s persistent symptoms. Despite these
efforts, Caleb’s condition remained unchanged, prompting Tiffany to seek
medical advice.During Caleb’s one-month checkup, his slow weight gain
caught Dr. Baker’s attention. Dr. Baker conducted a thorough examination
of Caleb’s chest and detected a murmur through careful auscultation
with a stethoscope. Concerned by this finding, Dr. Baker ordered both an
echocardiogram and an electrocardiogram (ECG) to further investigate
Caleb’s condition. Dr. Baker proceeded with an
echocardiogram and an ECG to conduct a comprehensive evaluation of
Caleb’s cardiac structure and function. These diagnostic tests confirmed
the presence of a ventricular septal defect (VSD), characterized by a
small hole between Caleb’s heart ventricles. Dr. Baker’s recommendation
for surgical intervention underscores the gravity of Caleb’s condition.
Despite the VSD’s small size, surgery is deemed necessary to mitigate
potential complications such as heart failure and to optimize Caleb’s
feeding tolerance and overall health.
Respond to the following classmate post (2): Caleb’s abnormal heart sounds tipped off Dr. Baker to a problem.
Normally, the heart makes two sounds, “lub-dub.” The first sound, “lub,”
happens when the heart valves close as the heart pumps blood out. The
second sound, “dub,” happens when different valves close as the heart
relaxes. Dr. Baker heard an extra sound called a murmur, which is caused
by blood flowing abnormally through the heart, likely due to a hole
between the heart’s right and left sides.
Tiffaney noticed something was wrong with Caleb because he had
trouble eating and cried a lot. At his one-month check-up, he had barely
gained any weight. Dr. Baker listened to Caleb’s heart and heard a
murmur, prompting further tests like an echocardiogram and an ECG. These
tests showed that Caleb had a ventricular septal defect, a small hole
in the heart wall. Dr. Baker explained that while the hole wasn’t big,
it was causing Caleb’s issues and would need to be repaired with
surgery. Tiffaney felt scared about the surgery but relieved to know
what was wrong.

The Assignment:
After reviewing the case and the accompanying case analysis questions, included in the document, answer the questions directly in a word document. When providing evidence to support your answers, be sure they evidenced-based, current (no more than 5 years old), and follow current standards of care. Follow APA 7th edition formatting, including a cover page and references. 
Mr. Raymond Jackson is a 68-year-old who is in the office today, on Monday, complaining of right eye pain. He states this started rather suddenly over the weekend. He has redness, itching, burning along the edge of his right eye lid. He reports no trauma, he thinks it started while he was sleeping Saturday night. Otherwise, he is in fair health, he has a history of Diabetes type 2, hypertension, hyperlipidemia and seborrheic dermatitis which he has seen a dermatologist for in the past. He still works part time as a school crossing guard at the neighborhood elementary school. He has been a widower for 2 years and he has 3 children who live out of the area. He worked for many years in construction, until the work
became more physically demanding. He has social security, and his medical coverage is through a Medicare Advantage plan, he does not qualify for Medicaid in his state. VS: BP 138/84 Pulse 88 Resp 18 Temp 97.8 02 Sat 96% Ht 70 inches Wt 190 lbs PMH: As stated in case presentation, also history of chronic low back pain. Allergies: NKDA Medications:
Glucophage 500mg 1 po BID
Metoprolol 25mg po daily Lisinopril 10mg po daily
Atorvastatin 20mg po daily
Ibuprofen 200mg 2 po very 6 hours as needed for back pain Social History: As described in case presentation. Also, he lives independently in a small apartment; he doesn’t know his neighbors very well but has some close friends from his old neighborhood. He uses public transportation to shop, visit friends and get to his medical appointments. He does not smoke, does not drink alcohol. ROS: Back pain today 2/10, right eye itching, feels like his right eye is very dry. Diagnostics/Assessment: Last HgA1c, 2 months ago, was 6.5
ANSWER THESE QUESTIONS:
1. What is the likely diagnosis of Mr. Jackson’s eye issue? List 3 differentials as well.
2. What are some contributing factors for your diagnosis? List 3 contributing factors.
3. What physical examination and diagnostic tests would you complete for Mr. Jackson at this visit?
4. Describe your treatment plan for this visit, including any follow up or referrals.
5. What Social Determinants of Health (SDOH) would you include in your plan?
6. Briefly describe a Medicare advantage plan.
I have upload the Soap templete to be used as an attachment.

Childhood Research Report Requirements:
A. Name of Disease/Illness/Disorder/Health Condition: Identify name, common and medical terms used.
B. Description:
1. State a description of the Disease/Illness/Disorder/Health Condition.
2. What is the causative agent? (name of pathogen, risk factors, behaviors)
3. What is/are the mode(s) of transmission? How does the disease/Illness/Condition develop?
4. What are the signs? (objective indicator(s), measurable, visible signs of illness such as rash, fever,
bleeding, and/or the behavior)
5. What are the symptoms? (subjective indicators of illness usually difficult to measure such as pain,
fatigue, weakness, restlessness)
If applicable:
Links to an external site.
9
1. Incubation period of disease? (time between pathogen entering system/body and the appearance
of signs/symptoms).
2. Communicable/Contagious period? (time period in which the disease can be spread from one
person to another)
C. Incidence and Prevalence:
1. Provide the incidence and prevalence of the Disease/Illness/Disorder/Health Condition.
2. Are the numbers increasing or decreasing?
3. Are there any trends?
D. Treatment:
1. Are there treatments available?
2. What is the treatment? Be specific
3. Where and how is the Disease/Illness/Disorder/Health Condition treated?
E. Prevention:
1. Discuss preventative measures that can be taken.
F. Community Impact:
1. What is being done at the federal, state, and community level to prevent and treat this disease.
(state program names or bills)
2. Are there any community, school, research programs in place? (Include program names for each)
G. Implications for the Educator/Teacher:
1. What types of actions/adjustments will a teacher in the school setting need to make for a child
with the Disease/Illness/Disorder/Health Condition?
2. Prevention: How could the school or classroom teacher prevent transmission?
3. Classroom Environment: What modifications might be required?
4. Adaptations of the curriculum: What types of curriculum changes will the teacher make for a
student(s) with this disease/health condition? Be specific
H. References:
 APA format
 Minimum 5 different sources – You may not use the class text as a source
 In text required (5)
 Complete reference page

Stress or more specifically stressors, can have both positive and negative effects on the body.
Some of the positive effects of stress include the following:
Stress can be the driving force that pushes us to succeed; to work harder.  When we are successful in a stressful situation, that helps to build confidence in ourselves and provides us with the confidence to attempt other challenges and also to be more likely to look at a stressful situation as one that we are able to handle.
Low levels of stress can stimulate the release of neurotrophins.  Neurotrophins are chemicals released by the nervous system that have many different functions, but one of the functions is to regulate neurotransmissions and the effectiveness of neurotransmission.  This can increase the ability to concentrate.
Stress can push you to change, to seek a new solution to a problem.
Stress can also have negative effects. Some of the negative effects of stress include:
Stress can have an adverse effect on mood promoting anxiety, feelings of loneliness, etc.
Stress can affect memory.
Chronic stress can lower the immune system.
Chronic stress can have an adverse effect on the cardiovascular system, the digestive system and more.
So how can we help to reduce chronic stress and turn stressors from a negative into a positive.  Identify one strategy that either you effectively use to reduce the negative effects of stress or a strategy that you would like to try.

If you can please combine all 3 documents, write an abstract, add an appendix, and make any connections necessary please for example make sure the chart correlates with the 
report

Answer the following questions in a detailed and well written manner.
Discussion Question 1: A stroke, called a brain attack, is not precisely the same as a heart attack in the brain. Research the differences by including a discussion of the various physiological and lifestyle factors, which are important in both ischemic stroke and heart disease. Also address the importance of timing in therapeutic interventions in each.
Question 2: What steps could you take to increase blood pressure screening in your community? Where would you refer those that need immediate medical attention and follow-up monitoring?
Please try to use resources provided and external resources in your research for the discussion (Please do not simply copy and paste from the websites – instead, summarize the information in your own words). 
You may want to visit the CDC website and review the risk factors for CVDs and which one s are modifiable and which ones are not. This will help you formulate a great response.

present a Powerpoint presentation on MULTIPLE SCLEROSIS. The presentation must include information about the:
Drug pharmacology, pharmacokinetics
Brand name
Generic name
Dosing
Indications for use
Side effects
Contraindications
Pregnancy class
You must also perform a cost analysis of the drug.
Provide a patient case study on a patient in which you would utilize the drug you have selected and include at least two peer-reviewed evidence-based studies related to the drug.
Describe the appropriate patient education. 
What is your role as a Nurse Practitioner for prescribing this medication to this patient on your case study presentation?
Describe the monitoring and follow-up.
Submission Instructions:
organized in current APA style including citation of references.
Incorporate a minimum of 4 current (published within last five years) scholarly journal articles within your work. 
PowerPoint presentation with 10-15 slides, excluding the title slide and the reference slide.
The presentation is clear and concise, and students will lose points for improper grammar, punctuation, and misspelling.

I have written my research paper. If you could write an abstract for it, a table of contents, aand appendix for it that would be great. i will submit an example of what it should look like and also the work i have done. if you could also make any corrections so it could meet apa7 requirements that would be great.