Juvenile Rheumatoid Arthriris Essays - Rheumatology, Arthritis

Juvenile Rheumatoid Arthriris A chronic, inflammatory disease that may cause joint or connective tissue damage. The onset occurs before Age 16. Causes, incidence, and risk factors: JRA is thought to belong to the collagen classes of disease (those diseases that involve connective tissue). It is a complicated disease. The primary manifestation is arthritis, but the disease may involve other body systems such as the heart and lining around the heart (pericardium), lungs and lining around the lungs (pleura), eyes, and skin. Systemic arthritis affects 20% of those with juvenile arthritis and includes fever, rash, and enlarged spleen (splenomegaly) in addition to joint inflammation. JRA is generally divided into five broad groups depending on whether a large number of joints are involved or just a few, whether the rheumatoid factor (a blood test) is positive or negative, and whether there is eye involvement or not. The five categories of JRA may be roughly broken down as follows: many involved joints and a positive rheumatoid factor many involved joints and a negative rheumatoid factor few involved joints and a positive antinuclear antibody few involved joints and a positive HLA B27 surface antigen systemic JRA (throughout the body) A specialist in rheumatology generally makes the category determination. The onset of arthritis may be slow or extremely rapid. An early sign of slow onset may be stiffness on arising in the morning. Swollen, painful joints characterize the arthritis of JRA with pain on motion and sometimes to touch. The skin over the joints is generally not red but can be. The systemic form of JRA may first appear with high fevers, chills and a rash but without joint pain. In the systemic form, arthritis may develop months after the appearance of the fever. The two forms of JRA where there are only a few joints involved often have associated eye disease. The most severe form of eye disease, chronic iridocyclitis of JRA, may lead to lead to visual problems or blindness. The milder form of JRA-associated eye disease is acute iridocyclitis, which generally heals without permanent damage. The cause of juvenile rheumatoid arthritis is unknown. Growth may be affected during periods of active disease. Girls are affected more often than boys are. The peak onset occurs between the ages of 2 to 5 years old and between 9 to 12 years old. Risk factors may be a family history of the disease and recent rubella infection or vaccine. Prevention: There is no known prevention for JRA. Symptoms: General symptoms: joint stiffness on arising in the morning limited range of motion slow rate of growth hot, swollen, painful joints fever, low grade (with multiple-joint type disease) fever, high spiking with chills (with systemic form of disease) rheumatoid rash rheumatoid nodules (at sites of pressure) Symptoms of eye involvement: red eyes eye pain photophobia visual changes Other symptoms: chest pain shortness of breath abdominal pain Signs and tests: Physical examination may show an enlarged liver (hepatomegaly), enlarged spleen (splenomegaly), or swollen lymph nodes (lymphadenopathy). There may also be signs of: anemia iridocyclitis pericarditis pleuritis myocarditis Tests include: CBC ESR ANA RA factor HLA antigens immunoelectrophoresis - serum synovial fluid analysis X-ray of a joint X-ray of the chest ECG slit-lamp exam of the eyes Treatment: Treatment is aimed at preserving mobility and joint function and supporting the patient and family through a long chronic illness. Therapeutic medications include: aspirin nonsteroidal anti-inflammatory agents (NSAIDS) corticosteroids topical ophthalmic corticosteroids mydriatics gold therapy chloroquine agents immune suppressing agents (rarely used in children) Note: Talk to your health care provider before giving aspirin or NSAIDS to children! Physical therapy and exercise programs may be recommended. Surgical procedures may be indicated, including joint replacement. Expectations (prognosis): JRA is seldom life threatening. Long periods of spontaneous remission are typical. Often JRA improves or remits at puberty. Approximately 75% of JRA patients eventually enter remission with minimal functional loss and deformity. The stress of illness can often be helped by joining a support group. Here, members share common experiences and problems.. Complications: loss of vision or decreased vision total joint destruction of the major weight-bearing joints chronic spondyloarthropathy

How to Use a Response Essay Sample Agreement

How to Use a Response Essay Sample AgreementIf you want to enter into a contract with your client, you may want to consider a response essay sample agreement. A contract is a legal document that provides the basics of how a business can operate and what services will be provided. By understanding this basic outline, both parties have the advantage of knowing exactly what they are signing before the business relationship begins.A response essay sample agreement must detail the end of this relationship, and a clear outline of what will happen between the parties after that. This is a way to set up guidelines for both parties. It is important to make sure that all details are clearly defined so that everything is clear to both parties at the beginning of a relationship.Every agreement should start with a specific topic of discussion. However, it is important to be clear on what the specific topic is. For example, it is okay to set up a topic for the first part of the agreement, but it m ight not be a good idea to begin with the ending.The second part of the agreement must contain specific topics for the two parties. First things first, both parties must agree on who will be the author of the essay. This is done by listing down who the author is. The other party is then required to agree as well, and the response must be written by the author.The response must also be acceptable to both parties. The essay must be a response to a similar question or challenge. It must be acceptable to both parties to be categorized as a response essay sample agreement because it makes both parties think about what they are agreeing upon.The final part of the agreement is an overview of the beginning and ending of the contract. These two parts will detail everything from the exact date that the contract will be established to when the agreement will be over. It is very important to know the exact dates so that both parties have a clearly outlined timeline for a business relationship. This helps to keep all parties focused on what is taking place during this specific time period.Finally, the agreement must give specifics about how the contract will be handled after it is over. It must list down when the agreement will be cancelled, how the relationship will be terminated, and what the final payment for services provided will be. The terms can be to meet at a certain time, or to meet again sometime in the future.When writing a response essay sample agreement, it is important to keep these points in mind. A good template can be used to quickly put together the outlines of what all the terms should be. It is also important to make sure the terms are properly set out to avoid any confusion down the road. This way, both parties are going to be pleased with the arrangement.

Free Essays on Family Assessment Assignment

Family Assessment Assignment The purpose of this paper is to present a family assessment. Community health nurses work with individual families and with families as an aggregate within the population (Clark, 2003). Several areas will be presented such as biophysical, psychological, physical environmental, sociocultural, behavioral and health system considerations. The data obtained during family health assessment enable the nurse to make informed decisions about the health care needs of families (Clark). Biophysical Considerations On the maternal side, this family has one living eighty five year old male and one living seventy seven year old female. Two of the paternal members are deceased at the age of forty and eighty-eight. There is one living fifty-three year old male and one living forty-eight year old female. This couple has three children, two males, age twenty and fifteen, and a female age eighteen. All of the above family members have accomplished age-appropriate developmental tasks. The younger male has a learning disability which does cause some excess stress in the family. This is an example of an extended family and also the dual-earner family. This family consists of two working parents with children and also includes a kin network which provides mutual support for the family (Clark, 2003). The younger family members are currently healthy and are not being treated for any health conditions. The eighty-five year old male is currently undergoing treatment for colon-rectal cancer. This treatment consists of weekly visits to a doctor’s office for chemotherapy. There is a family history of genetic pre-disposition to cancer as his mother had this illness also. Psychological Considerations The typical mode of communication in the family is verbal. The family uses the switchboard pattern, in which all members have reciprocal communication. A successful pattern of communication is the â€Å"switchboard†... Free Essays on Family Assessment Assignment Free Essays on Family Assessment Assignment Family Assessment Assignment The purpose of this paper is to present a family assessment. Community health nurses work with individual families and with families as an aggregate within the population (Clark, 2003). Several areas will be presented such as biophysical, psychological, physical environmental, sociocultural, behavioral and health system considerations. The data obtained during family health assessment enable the nurse to make informed decisions about the health care needs of families (Clark). Biophysical Considerations On the maternal side, this family has one living eighty five year old male and one living seventy seven year old female. Two of the paternal members are deceased at the age of forty and eighty-eight. There is one living fifty-three year old male and one living forty-eight year old female. This couple has three children, two males, age twenty and fifteen, and a female age eighteen. All of the above family members have accomplished age-appropriate developmental tasks. The younger male has a learning disability which does cause some excess stress in the family. This is an example of an extended family and also the dual-earner family. This family consists of two working parents with children and also includes a kin network which provides mutual support for the family (Clark, 2003). The younger family members are currently healthy and are not being treated for any health conditions. The eighty-five year old male is currently undergoing treatment for colon-rectal cancer. This treatment consists of weekly visits to a doctor’s office for chemotherapy. There is a family history of genetic pre-disposition to cancer as his mother had this illness also. Psychological Considerations The typical mode of communication in the family is verbal. The family uses the switchboard pattern, in which all members have reciprocal communication. A successful pattern of communication is the â€Å"switchboard†...

Business Analysis Of HSBC

Business Analysis Of HSBC HSBC is public limited bank and it’s headquartered is located in London, England since 1993. HSBC bank was founded in 1865 in and it was started with name † The Hong kong and Shanghai Banking corporation â€Å".The bank has lots of branches throughout the world. HSBC bank offers wide range of banking, Investment and financial service to high and economic customers. It holds international network of 8000 properties in 88 countries and regions in Europe, Hong kong, Rest of Asia-Pacific, The Middle East, The Americas and Africa. Previously, the Middle East is known as part of ‘Rest of Asia -Pacific ‘. HSBC offers comprehensive range of financial service within these international network. Banking service such as Credit and debit accounts, bank loans (secured loans, loans, unsecured loans, car loans etc.), mortgages, overdraft facility, and insurance are being served by the bank. It also provides Internet banking and Offshore banking. HSBC is one of the worldâ €™s largest banking and financial service group with 8th rank, according to Forbes Magazine. It has market capitalisation of US$ 199 billion since 31st December 2009. It is listed on the so many stock exchanges like London, Hong kong, New York , Barmuda and Paris; it is also part of the FTSE 100 index and HangSeng index. HSBC is also world’s first bank which was opened internationally that means â€Å"World’s Local Bank† and it was financed various projects like Railroad Building due to mordenization in early 20th century. History of HSBC: The history of HSBC is as old as extremely intresting for the each and every person and organization who wants great deal with the bank around the globe. Furthermore, bank is offering large amount of service to an individuals and institutions. FOUNDATION AND GROWTH : HSBC originally stands from â€Å"The Hongkong and Shanghai Banking Corporation † which is established by Scot Thomas Sutherland in Hongkong ( 3rd marc h ) in 1865. Then and as now,1 Queen’s Road Central was bank’s headquartered in Hongkong , plus another was opened in Shanghai one month later in 3rdapril 1865 to finance growing trade between China and Europe. In addition, one year later the London office was opened. During the nineteenth and early twentieth century, the bank opened its more branches in China, Asia, Japan, Europe and North America to provide financial service for its clients. Throughout the Second war the bank closed its many branches due to an international financial crisis and the head office was temporarily moved from Hongkong to London. Then after, the bank played major roll in rebuilding of Hongkong economy and that was the time for geographical spread through acquisition and alliances . In 1959, the bank purchased two banks that was The British Bank of Middle East and The Mercantile Bank (based in India). The Bank moved to Canadian and Australian market to expand its business during 1981-1986. I n 1987 The Marine Midland Bank (Now HSBC Bank of USA) became a member of the group. In 1991, HSBC Holding PLC was established and it became parent company to The Hong kong and Shanghai Banking Corporation, the shares were traded in both London Hong -kong stock exhanges.

Paper 2 Essay Example | Topics and Well Written Essays - 500 words - 1

Paper 2 - Essay Example He argues that good performance profiles should define success and thus meeting the minimum requirements (Uttaro, Paras 2-3). Management position also requires a good performance profile, which removes non-fact based opinions. It is wise to avoid personal bias by using performance profiles to be aware of characters that have been proven by scientists to make employees satisfied. The other thing is by staying current. Good performance profiles are made by using recent performance of your employees. Taking note of current performance of employees is a good tool when developing performance profiles. The other important aspect is developing performance profile that maximizes odds. Making use of performance profiles enables one easily to hire people who will be productive and stay longer in your firm (Uttaro, Paras. 4- 6). After school, accountancy will be the career of choice. The job requires knowledge in preparing financial statements. It also requires a commitment, speed, and accuracy, and you need to have computer skills especially in Microsoft Excel. The best performance profile for the accounting job that will lead to effective performance can be seen below. First is to prepare a comprehensive plan to achieve accounting objectives with a distinct period that you want to accomplish. Secondly, one should conduct a comprehensive operational review. Work with other financial accountants and assess all aspects of the company’s operating performance. Develop a plan of action to deal with each of the issues. The other thing is to address operational issues. If the company is under- performing, you need have a group of people to execute the task and solve pertinent issues. Another thing is to evaluate the financial strength of the company. You need to review all the historical financial data, bu dgets, and forecasts. Evaluate critical areas of concern and determine new ways to improve performance (Uttaro, Para 8). Considering the

No topc Essay Example | Topics and Well Written Essays - 750 words - 1

No topc - Essay Example Sometimes women are the suppressed gender in our society. Conflict arises relating to what are the socially accepted roles for women. What are the typical gender issues in our society today? Why do gender issues focus on women? Historical accounts about women’s societal roles can be traced back during the time of Abraham and Jesus. We can see how women were treated during those times based on the Bible. Men’s societal roles during this time were outside the home, as dictated by the traditional society. They work mostly in the plantation, work as carpenters, palace guards, while women nurse their children and always stay at home to do household chores. During the early colonial period where galleon trade started conquering the world, women remained domesticated. Education was only given to men who will be part of this trade. During the 19th century, different types of government began to emerge, yet these governments were not aware of gender inequality because they only continue the same norm and culture of men dominating women. The establishment of these governments was created through elections. However, women were not given the right to suffrage / vote until 1920s. Suffrage issues began to alarm some women who can’t bear the unequal rights given to women. They believe that they are also part of the success of the society and can decide whom to vote. Because of some uprisings of these women in the 19th century, women were persecuted for fighting for their rights. Men believed that women are not yet ready to take on responsibilities outside their home. Still, more women fought against these socially constructed norms about them. Some women were not fully recognized for their contributions in the society. Mostly men were given credits and privileges. We can call this kind of society as patriarchal, for believing men are more sufficient and rational as women. Economies of European countries before were ruled by men

Pauls views on government :: essays research papers

Paul’s views on Government   Ã‚  Ã‚  Ã‚  Ã‚  The first part of Paul’s letter to the Romans is very important because during the beginning he gives his credentials so that he may give authenticity to his letter. He declares himself â€Å"a servant of Jesus Christ called to be an apostle† Romans 1:1. This is to give himself credibility when he discusses God’s will.   Ã‚  Ã‚  Ã‚  Ã‚  The meat and bones of this book starts with the idea of election. The current government of the Romans was mainly aristocratic with the largely powerless senate and the ever powerful Cesar. Depending on your choice of interpretation you might think that Paul deals with the act of free will in Ch. 9. A Calvinistic view would dive into God giving us free will, and ending up believing that God causes us to do the things that we do. If you believe that God created us all in his image then you would be against the Roman type of government because if we are all created in God’s image we are all created equally and no one person can be placed above another.   Ã‚  Ã‚  Ã‚  Ã‚  Paul, as well many of the Israelites hated the Roman government and its methods (e.g. crucifixion). But unlike many of his peers Paul felt that as cruel and unsatisfactory the Romans treated the Israelites Paul believed that â€Å"those authorities that exist have been instituted by God. Therefore whoever resists authority resists what God has appointed, and those who resist will incur judgment† Romans 13:1-2. Paul believes that all the current institutions were created by God. This might be because Paul himself was a minister of God that was ordained by God. He might also have believed the political institutions were like he was, ordained by God.   Ã‚  Ã‚  Ã‚  Ã‚  Paul also seemed to believe that since everything was according to God’s will that God created a state around and for the Israelites. A big portion of this gospel is also dedicated to the spreading of the gospel to everyone, even the gentiles. While there were some people that Paul considered ‘weak’ Christians, Paul still believe that the gospel was for them as well. Pauls views on government :: essays research papers Paul’s views on Government   Ã‚  Ã‚  Ã‚  Ã‚  The first part of Paul’s letter to the Romans is very important because during the beginning he gives his credentials so that he may give authenticity to his letter. He declares himself â€Å"a servant of Jesus Christ called to be an apostle† Romans 1:1. This is to give himself credibility when he discusses God’s will.   Ã‚  Ã‚  Ã‚  Ã‚  The meat and bones of this book starts with the idea of election. The current government of the Romans was mainly aristocratic with the largely powerless senate and the ever powerful Cesar. Depending on your choice of interpretation you might think that Paul deals with the act of free will in Ch. 9. A Calvinistic view would dive into God giving us free will, and ending up believing that God causes us to do the things that we do. If you believe that God created us all in his image then you would be against the Roman type of government because if we are all created in God’s image we are all created equally and no one person can be placed above another.   Ã‚  Ã‚  Ã‚  Ã‚  Paul, as well many of the Israelites hated the Roman government and its methods (e.g. crucifixion). But unlike many of his peers Paul felt that as cruel and unsatisfactory the Romans treated the Israelites Paul believed that â€Å"those authorities that exist have been instituted by God. Therefore whoever resists authority resists what God has appointed, and those who resist will incur judgment† Romans 13:1-2. Paul believes that all the current institutions were created by God. This might be because Paul himself was a minister of God that was ordained by God. He might also have believed the political institutions were like he was, ordained by God.   Ã‚  Ã‚  Ã‚  Ã‚  Paul also seemed to believe that since everything was according to God’s will that God created a state around and for the Israelites. A big portion of this gospel is also dedicated to the spreading of the gospel to everyone, even the gentiles. While there were some people that Paul considered ‘weak’ Christians, Paul still believe that the gospel was for them as well.