The Passing of the Emancipation Proclamation as the Result...

The Passing of the Emancipation Proclamation as the Result of Lincoln’s Desire to Undermine the Southern Economy Abraham Lincoln’s Emancipation Proclamation completed the most significant u-turn in American history. Months before, in the Crittendon Resolution, Lincoln had explicitly stated that Union forces would not target Southern plantations, and that the South would be welcomed back into the Union with or without the slave system. At this point, Lincoln regarded slavery as a potentially divisive issue and, as noted by the historians Johansson and Hofstatder, aimed to avoid anything that would associate him as being either for or against its abolition. However, by 1863, Northern forces had†¦show more content†¦The highly industrialised Northern economy was perfectly adapted to the extra demand, and was able to facilitate the production of all the equipment needed. Conversely, the Southern economy was sluggish in its attempts to update its primitive economy, and because of this remained reliant on the slave trade. Thus, in depriving the South of a big proportion of its work force, Lincoln was able to significantly reduce their production capabilities. More directly, the North benefited by being able to acquire the slaves for themselves. This had the advantage of increasing the number gap twice: the Northern soldiers occupying Southern plantations would be free to fight again, and the released blacks themselves could become Northern fighters. Thus, the Emancipation Proclamation was seen not only as a way of weakening the South, but of strengthening the North. In such a way, Lincoln was able to widen the disparity between North and South. From a popular perspective, slavery was seen as a symbol of Southern independence. Being otherwise incapacitated by the ongoing Civil War, the Confederate states’ only outlet was the desire to inflict some form of victory over the domineering North. The obliteration of the slave trade would end any hope of this moral-boosting ambition. With the 1864

Electronic medical records systems Free Essays

INTRODUCTION Scientific and social changes of the 21st century have brought a radical change in the Health care delivery system with excellent technological innovations. One such innovation is the Electronic Medical Record System. An electronic medical record (EMR) is a medical record in digital format. We will write a custom essay sample on Electronic medical records systems or any similar topic only for you Order Now The health care sector is accountable today with an alarming rise in medical litigations.This legal accountability of the health care system has given rise to a number of documents that have to be recorded ,preserved and made available to the patients on demand. The documentation includes, 1.Diagnosis and Treatment Report which very Health Care delivery center today provides to the patient on the details of the diagnosis of the disease with follow up instructions, the Medicine information and the allergy reactions that could follow; dietary restrictions, dos and don’ts, restrictions and exercises prescribed. They take an acknowledgement either from the patient or an authorized person after receiving the report. This documentation serves a key purpose in medical practice.2.The Health Record which is the proper documentation of records of all treatments and medications, as well as a record of a patient’s reactions and behavior. The health record is the written and legal evidence of treatment. This reflects only facts and not the judgment of the doctor. Careful and accurate documentation is vital for patient welfare and that of the doctor. Documentation includes, medication administered, treatments done with date time, factual, objective and complete data, with no blank spaces left in charting, on flow sheets or on check lists, calls made to health care team, client’s response, signature of the nurse in every entry and consent for treatment. A private hospital in Milan, Italy, has been asked to handover for police verification of the medical records of at least twenty one cases who had heart valve surgery, following complaints that the surgeon replaced heart valves even in patients who did not need them replaced.3. Informed Consent, which is a document, recorded before any terminally ill person receives his chemotherapy or an invasive procedure. The patient or his/her health attorney should give a well-documented informed consent before such procedures. Informed consent means that tests, treatments and medications have been explained to the person, as well as outcomes, possible complications and alternative procedures. Any medical hospital can be pushed into a center of a litigation storm after allegations without informed consent.4.Medical Billing and Insurance, which are part of the health care system in USA. Electronic medical record keeping facilitates access of patient data by physicians at any given location ,accurate   claims processing by insurance companies , building automated checks for drug and allergy interactions,clinical notes and laboratory reports.The term electronic medical record can be expanded to include systems which keep track of other relevant medical information. THE TECHNOLOGY Five levels of an Electronic HealthCare Record (EHCR) keeping can be classified as follows; 1.The Automated Medical Record ,which is a paper-based record with some computer-generated documents. 2.The Computerized Medical Record (CMR), which makes the documents of level 1 electronically available. 3.The Electronic Medical Record (EMR) which restructures and optimizes the documents of the previous levels ensuring inter-operability of all documentation systems. 4.The Electronic Patient Record (EPR) which is a patient-centered record with information from multiple institutions.5.The Electronic Health Record (EHR) adds general health-related information to the EPR that is not necessarily related to a disease. The development of standards for EMR interoperability is vital because of the fact that without interoperable EMRs, practicing physicians, pharmacies and health care institutions cannot share patient information, which is necessary for timely patient-centered care. There are many standards relating to specific operation of   EMRs in the USA and across the globe. These include â€Å"ASTM International continuity of care record † in which patient health summary is based upon XML; â€Å"ANS1 X12†,which is a set of protocols used for transmitting any data including billing information; â€Å"CEN†,which is the European Standard for EMR; â€Å"DICOM†,A popular standard in radiology record keeping and â€Å"HL7† which is commonly used in clinical document architecture applications. There are many software programs specially developed for electronic record keeping. This includes ‘Doctors partner’, an advanced Electronic Medical Records (EMR) System with Integrated Appointment Scheduling Billing, Prescription Writer, Transcription Module, Document Management and Workflow Management built to meet HIPAA standards. ‘Practice Partner Patient Records’ is an award winning electronic medical records (EMR) system, allowing practices to store and retrieve patient charts electronically. There are innumerable such branded medical record softwares available today (Ringold et.al.,2000) The American Medical Association and 13 other medical groups representing 500,000 physicians have signaled their intention to go electronic with the AMA formed Physicians’ â€Å"Electronic Health Record Coalition† to recommend affordable, standards-based technology to their constituents. President Bush has also promoted a nationwide computerized medical records system in a recent visit to a children’s hospital at Vanderbilt University. THE COST The National Academy of Sciences report states that the health care industry spent between $10 and $15 billion on information technology in 1996. RED medic Inc., a California based firm have introduced a cheap online medical record service with an annual membership of about $35. The company Web site will collect, store and access everything ever wanted by health-care professionals to know about a patient’s medications, allergies, immunizations, conditions, doctors, emergency contacts and insurance providers. The system will store and transmit more complex information such as advance directives, EKGs and other essential medical documents and diagnostic imaging techniques. This health information service is capable of delivering information to any doctor or hospital, anytime, within the United States. RISK ASSESSMENT Although the issue of the privacy of patient records has received due attention in the last two years with arguments that Electronic medical records presents new threats to the privacy of patient-identifiable medical records, The Health Insurance Portability and Accountability Act of 1996 paved ways to protect the privacy of medical records Thus, any violation on these lines will be violation of the basic law. Under data protection legislation and the law in USA, the responsibilty for patient records in any form including films and tracings from diagnostic imaging procedures such as x-ray, CT, PET, MRI, ultrasound, etc.   lies always on the creator and custodian of the record, who is usually a health care practice or facility and   the patient owns the information within the record and has a right to view the originals, and to obtain copies under law. Thus, electronic medical record system is a technologically viable cost effective system that has to be utilized by the health care sector governed by legal and ethical principles. CONCLUSION EMRs can serve a great purpose by making the patient data available to any authorized physician   or   patient anywhere and anytime towards more transparent health care   when monitored effectively. REFERENCE Hallvard Là ¦rum, MD, Tom H. Karlsen, MD, and Arild Faxvaag, MD, PhD. â€Å"Effects of scanning and eliminating paper based medical records on hospital physician’s clinical work  Ã‚   practice†.. Journal of the American Medical Informatics Association 10: 588-595. 2003. Medical Board of California: Medical Records – Frequently Asked Questions. Ringold, JP Santell, and PJ Schneider. â€Å"ASHP national survey of pharmacy practice in acute care   settings: dispensing and administration–1999†. American Journal of Health-System   Pharmacy 57 (19): 1759-75. 2000. US Code of Federal Regulations, â€Å"of Individually Identifiable Health Information†   Title 45, Volume 1,October 1, 2005. How to cite Electronic medical records systems, Essay examples

Corynebacterium Diphtheriae Infections †Free Samples to Students

Question: Discuss about the Corynebacterium Diphtheriae Infections. Answer: Introduction: Once upon a time, when the world was still dealing with other deadly pathogens, troubling humankind with respiratory tract related diseases, a new contender was preparing to steal the show with its antics management. I had the honour of causing one of the widely known infectious diseases, Diphtheria. May be it is not entirely necessary, but the opening credits of my story needs to be handed down to Edwin Klebs (Farfour et al., 2012). In the year 1883, he had made the effort of introducing me to the world as the causative organism for the disease Diphtheria, popularly known as the strangling angel of children (Byard, 2013). Now that was some fancy name. However, only limited imagination leads to some name like Corynebacterium diphtheriae. I cannot entirely blame them given that the word Diphther has Greek origin, which stands for membrane (Goldman and Green, 2014). I was isolated from the pseudo membrane in the pharynx, which was a resultant of the necrotic toxin that I am able to pro duce (Goldman and Green, 2014). Well, the family needs a mention here and therefore a rough outline has been drawn in figure 1 to typically portray my heredity. Before humanity wipes my name from the face of Earth, maybe it is time that I should present myself, tell my story in my own words, my glorified days of terror. My popularity was extremely short lived, thanks to Freidrich Loeffler (Doyle et al., 2017). Yes, this man decided to end my tyranny in the year 1884 by spilling my secrets in front of the whole world. He had discovered that I could be cultured only from the nasopharyngeal cavity (Burkovski, 2016). He was also responsible for revealing my secret potent weapon to the world, the diphtheria toxin. He had stated that the toxin was capable of causing damage to organs. I was too sure about myself; I knew I could terrorize the world a little longer. Then it was not very long when Emil von Behring, in the year 1890, brought my terror to a standstill when he landed up isolating the antitoxin against diphtheria from blood samples, collected from a horse infected with diphtheria (Gillespie, Bamford and Bamford, 2012). He was also responsible for developing the first vaccine in the year 1913 against the diphtheria toxin (Burkovski, 2014). My brothers in arms, Corynebacterium ulcerans and Coryneba cterium pseudotuberculosis, are also able to produce the diphtheria toxin (de Mattos et al., 2014). However, the process of infecting the host, which may consist of both human and animal, greatly differs from mine. I have been known to be a Gram-positive organism, and I am known to be aerobic in nature (Gillespie, 2014). I am non-motile and do not have a capsule, however, I am club shaped. Figure 2 somewhat depicts me in my true form, however, I beg to differ. I am more glorified in appearance that just a rod-shaped bacilli on a microscopic field. My cell wall consists of sugars such as arabinose, mannose and galactose. My favourite source of nutrition happens to be nicotinic and patothenic acids (Reardon-Robinson et al., 2015). Based on the biochemical properties that I possess, I can be described as gravis, mitis, intermedius and belfanti (Clinton et al., 2013). I am known to cause the disease diphtheria, an infectious disease, which is transmitted through respiratory droplets. I locally colonize the mucosa of several anatomical sites within the body of the host, they include, pharyngeal, laryngeal, umbilical, genital, nasal, cutaneous, conjunctival (Zasada, 2013). The pharynx and larynx are my favourite spots for manifestation and therefore on colonization management, necrotic membranes appear that are either grey, translucent or black in colour. The pseudomembrane that I form consists mainly of fibrin, inflammatory cells. The colonization also results in the enlargement of the lymph nodes, which restricts swallowing, and breathing by the host as the lumen of the larynx and pharynx narrows (Sangal et al., 2015). The size of the neck increases too. My potent weapon of destruction, the toxin is able to damage the fibres of the cardiac muscle resulting in the blockage of the heart (Peixoto et al., 2014). My toxin is even capable of demyelinating the nerves, paralysing the palate and the ocular muscles (Gillespie, Bamford and Bamford, 2012). My infamous toxin consists of two fragments, namely N-terminal fragment A and a fragment B (Cohen and Van Heyningen, 2012). The N-terminal fragment A is known as the catalytic domain and it is responsible in catalyzing the NAD+ dependent ADP- ribolysation of EF2. This spews trouble for the eukaryotic cells as the protein synthesis is inhibited (Sekura, 2012). On the other hand, fragment B consists of the transmembrane and receptor binding domains that are responsible f or helping me bind to the cell surface receptor and helps me in delivering the fragment A into the cytosol (Sekura, 2012). I like the extent of destruction I am able to cause. The extent of fatality the toxin can bring about, as little as 100-150 ng/kg of body weight rather makes me giddy. However, the penny had just dropped and I had soon realized my limitations. The life threatening effect of my toxin can be easily neutralized with an antitoxin. The swift application of the diphtheria antitoxin (DAT) along with a conjunct antibiotic therapy happens to cure the people (Both et al., 2014). Now that was some serious bad news for me. I must admit, it was a very difficult job to maintain the top spot in being a respiratory tract related disease-causing pathogen. With the combating solutions being devised by humanity, it was getting difficult to keep up. Efficient and methodical immunization programs have helped several developed countries to control me. However, nobody could save them from my wrath for very long. I have happened to make a grand entry in the scene by terrorizing the eastern European countries in my wake (Wagner et al., 2012). These countries are some of the most popular tourist destinations in the world. Due to the resultant collapse of the immunization programs, the risk of occurrence of diphtheria has increased in these parts. Now that is one bit of good news for me. As long as humanity does not devise improved DATs, I will keep coming back. After all, it is an expensive process and therefore it is not even available in adequate quantity for every individual. There are only very few places in the world that manufacture these drugs. Popularly known producers of DAT are Microgen (Moscow) and Vins Bioproducts (Hyderabad) (Zasada, 2015). I should be worried if the preclinical studies involving the Anti-diphtheria monoclonal antibodies (mAbs) become successful (Sevigny et al., 2013). PCR-based diagnostic methods can also prove to be a headache (Both et al., 2013). It will get difficult to pose as a health threat henceforth. The immunization program of DTP3 vaccination among infants as seen in the year 2016 has been shown in the figure 3. Funny, they only realized the emergency when they found the number of infected to rise. I was feeling important all over again. Over the years, several improved detection methods for the detection of the diphtheria toxin has been developed. Worrisome, thoroughly worrisome for me as one can see. Methods such as Immunochromatographic strip test (ICS), Cytotoxicity test, Matrix-assisted-laser-desorption/ionization time-of-flight mass-spectrometry (MALDI-TOF) and Elek ouchterlony test management (Berger et al., 2014). Then I do not think I will be able to continue this for very long. Figure 4 seem to show the reduction in the reported cases of diphtheria over years stretching from 1980 to 2016. Human beings are snooping into my genetic makeup and are working towards the molecular basis that defines my pathogenicity (Both et al., 2015). If appropriate typing methods could be used then even the epidemics could also be predicted. Oh, how terribly it can spell disaster for me. MLST (Multi Locus Sequence Typing) has been able to avoid several limitations faced by previous researchers by analyzing the information related to the nucleotide within the selected housekeeping genes (Both et al., 2015). Then there are these groups of people, dedicated towards a pangenomics project, which might just help me, get a bigger place on the evolution map as a human pathogen (Trost et al., 2012). My days might just finally be over if humankind succeeds to establish it. The epidemiology and the pathogenesis of my non-t oxigenic strains have to be thoroughly studied though. Until then I do not wish to bid adieu and continue in living up to my reputation of being a hellion. References: Berger, A., Hogardt, M., Konrad, R. and Sing, A., 2014. Detection methods for laboratory diagnosis of diphtheria. InCorynebacterium diphtheriae and related toxigenic species(pp. 171-205). Springer Netherlands. Both, L., Banyard, A.C., van Dolleweerd, C., Wright, E., Ma, J.K.C. and Fooks, A.R., 2013. Monoclonal antibodies for prophylactic and therapeutic use against viral infections.Vaccine,31(12), pp.1553-1559. Both, L., Collins, S., de Zoysa, A., White, J., Mandal, S. and Efstratiou, A., 2015. Molecular and epidemiological review of toxigenic diphtheria infections in England between 2007 and 2013.Journal of clinical microbiology,53(2), pp.567-572. Both, L., White, J., Mandal, S. and Efstratiou, A., 2014. Access to diphtheria antitoxin for therapy and diagnostics.Euro Surveill,19(24), pp.2-2. Burkovski, A., 2014. Diphtheria and its etiological agents. InCorynebacterium diphtheriae and Related Toxigenic Species(pp. 1-14). Springer Netherlands. Burkovski, A., 2016.Corynebacterium diphtheriae and related toxigenic species. Springer. Byard, R.W., 2013. DiphtheriaThe strangling angelof children.Journal of forensic and legal medicine,20(2), pp.65-68. Centre for Disease Prevention and Control (CDC). Diphtheria. https://www.cdc.gov/diphtheria/about/photos.html [Accessed on 29th Aug 2017] Clinton, L.K., Bankowski, M.J., Shimasaki, T., Sae-Ow, W., Whelen, A.C., O'Connor, N., Kim, W. and Young, R., 2013. Culture-negative prosthetic valve endocarditis with concomitant septicemia due to a nontoxigenic Corynebacterium diphtheriae biotype Gravis isolate in a patient with multiple risk factors.Journal of clinical microbiology,51(11), pp.3900-3902. Cohen, P. and Van Heyningen, S. eds., 2012.Molecular action of toxins and viruses(Vol. 2). Elsevier. Collins, M.D. and Cummins, C.S., 1986. Genus Corynebacterium.Bergey's manual of systematic bacteriology,2, pp.1266-1276. de Mattos Guaraldi, A.L., Hirata, J.R. and de Carvalho Azevedo, V.A., 2014. Corynebacterium diphtheriae, Corynebacterium ulcerans and Corynebacterium pseudotuberculosisGeneral aspects. InCorynebacterium Diphtheriae and Related Toxigenic Species(pp. 15-37). Springer Netherlands. Doyle, C.J., Mazins, A., Graham, R.M., Fang, N.X., Smith, H.V. and Jennison, A.V., 2017. Sequence Analysis of Toxin GeneBearing Corynebacterium diphtheriae Strains, Australia.Emerging infectious diseases,23(1), p.105. Farfour, E., Badell, E., Zasada, A., Hotzel, H., Tomaso, H., Guillot, S. and Guiso, N., 2012. Characterization and comparison of invasive Corynebacterium diphtheriae isolates from France and Poland.Journal of clinical microbiology,50(1), pp.173-175. Gillespie, S., Bamford, K. and Bamford, K.B., 2012.Medical microbiology and infection at a glance. John Wiley Sons. Gillespie, S.H., 2014.Medical microbiology illustrated. Butterworth-Heinemann. Goldman, E. and Green, L.H. eds., 2015.Practical handbook of microbiology. CRC Press. Peixoto, R.S., Pereira, G.A., dos Santos, L.S., Rocha-de-Souza, C.M., Gomes, D.L.R., dos Santos, C.S., Werneck, L.M.C., de Oliveira, A.A.D.S., Hirata Jr, R., Nagao, P.E. and Mattos-Guaraldi, A.L., 2014. Invasion of endothelial cells and arthritogenic potential of endocarditis-associated Corynebacterium diphtheriae.Microbiology,160(3), pp.537-546. Reardon?Robinson, M.E., Osipiuk, J., Jooya, N., Chang, C., Joachimiak, A., Das, A. and Ton?That, H., 2015. A thiol?disulfide oxidoreductase of the Gram?positive pathogen Corynebacterium diphtheriae is essential for viability, pilus assembly, toxin production and virulence.Molecular microbiology,98(6), pp.1037-1050. Sekura, R. ed., 2012.Pertussis toxin. Elsevier. Sangal, V., Blom, J., Sutcliffe, I.C., von Hunolstein, C., Burkovski, A. and Hoskisson, P.A., 2015. Adherence and invasive properties of Corynebacterium diphtheriae strains correlates with the predicted membrane-associated and secreted proteome.BMC genomics,16(1), p.765. Sevigny, L.M., Booth, B.J., Rowley, K.J., Leav, B.A., Cheslock, P.S., Garrity, K.A., Sloan, S.E., Thomas, W., Babcock, G.J. and Wang, Y., 2013. Identification of a human monoclonal antibody to replace equine diphtheria antitoxin for treatment of diphtheria intoxication.Infection and immunity,81(11), pp.3992-4000. Trost, E., Blom, J., de Castro Soares, S., Huang, I.H., Al-Dilaimi, A., Schrder, J., Jaenicke, S., Dorella, F.A., Rocha, F.S., Miyoshi, A. and Azevedo, V., 2012. Pangenomic study of Corynebacterium diphtheriae that provides insights into the genomic diversity of pathogenic isolates from cases of classical diphtheria, endocarditis, and pneumonia.Journal of bacteriology,194(12), pp.3199-3215. Wagner, K.S., White, J.M., Lucenko, I., Mercer, D., Crowcroft, N.S., Neal, S., Efstratiou, A. and Diphtheria Surveillance Network, 2012. Diphtheria in the postepidemic period, Europe, 20002009.Emerging infectious diseases,18(2), p.217. World Health Organization (WHO). Immunization Surveillance, assessment and monitoring. https://www.who.int/immunization/monitoring_surveillance/burden/diphtheria/en/ [Accessed on 29th Aug 2017] Zasada, A.A., 2013. Nontoxigenic highly pathogenic clone of Corynebacterium diphtheriae, Poland, 20042012.Emerging infectious diseases,19(11), p.1870. Zasada, A.A., 2015. Corynebacterium diphtheriae infections currently and in the past.Przegl Epidemiol,69, pp.439-444.