The newest is the nucleic acid amplification test. It has 92-96% sensitivity and 94-99% specificity, as compared with culture tests (Norris). The Centers for Disease Control and Prevention recommends the maintenance of a low threshold to physicians when diagnosing pelvic inflammation disease because of the lack or absence of significant negative changes. The Center recommends diagnosing women with PID and who experience uterine and adnexal painfulness or cervical tenderness during the examination. Women who have urogenital disease can submit to the nucleic acid amplification text by endocervical or urine sample. Endocervical samples are, however, preferred, a urine samples have lower sensitivity (Miller).
Treatment

The Centers for Disease Control and Prevention revised its guidelines and now recommends the use cephalosporins in the treatment of gonorrhea and PID (Armstrong, 2007). This class of drugs has replaced fluoroquinolones, which have been popularly used since 1993. Fluoroquinolones have been the choice drugs because of their…...

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Bibliography

Armstrong, C. (2007). CDC changes guidelines for gonorrhea. American Family

Physician: the Academy of American Physicians. Retrieved on November 26, 2008 from  http://findarticles.com/p/articles/mi_m3225/is_11_75/ai_n19377313?tag=content;col1 

Javanbakht, M., et al. (2000). Increases in gonorrhea - eight Western states: 2000-2005. Morbidity and Mortality Weekly Report: Government Printing Office. Retrieved on November 26, 2008 at  http://findarticles.com/p/articles/mi_m0906/is/_10_56/ai_n2794120?tag=content;col1 

Justesen, S (2002). Slowing the spread of gonorrhea. Nursing: Springhouse Corporation. Retrieved on November 26, 2008 at  http://findarticles.com/p/articles/mi_m3689/is_200204/ai_n90666095?tag=content;col1

STDs: A MAJO CONTEMPOAY PUBLIC HEALTH CONCEN
Sexually Transmitted Diseases

Given the advances in medicine and public health over the past several decades, most people might assume that the incidence and prevalence of sexually-transmitted diseases (STDs) is declining; however, the scientific evidence suggests otherwise. ecent estimates from the Centers for Disease Control and Prevention (CDC) in the United States suggest that 20 million new STD infections occur every year and cost the U.S. health care system close to $16 billion dollars annually (CDC, 2013). This is up from 12 million STD infections and $10 billion dollars annually during the mid-1990s (Zenilman, 2004). In 2011, reports of chlamydia incidence set another annual record, double from what it was just 10 years ago (CDC, 2011). To better understand the health threats facing Americans when they engage in sexual activity this report will review what is known about the most common STDs infecting the population.…...

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References

CDC. (2013). CDC Fact Sheet: Incidence, prevalence, and cost of sexually transmitted infections in the United States. Retrieved from:  http://www.cdc.gov /std/stats/STI-Estimates-Fact-Sheet-Feb-2013.pdf.

CDC. (2011). Sexually Transmitted Disease Surveillance, 2011. Altlanta, GA: Department of Health and Human Services. Retrieved from:

Medical Ethics
Sexually Transmitted Diseases and Contact Tracing

MG is a 27-year-old graduate student, recently married, who comes into the student health clinic for a routine pelvic exam and Pap smear. During the course of the exam, the gynecology resident performing the exam obtains the Pap smear, but also obtains cervical cultures for gonorrhea and chlamydia. The examination concludes uneventfully. Several weeks later, MG receives a postcard indicating that the Pap smear was normal, with no evidence of dysplasia, but that the cervical culture for gonorrhea was positive. The card instructs her to come into the clinic to discuss treatment, and that "public health authorities" have been notified for contact tracing, which refers to the identification and diagnosis of sexual partners, as required by law. The young woman is terrified that her husband will be contacted. Is contact tracing ethically justified?

While it is definitely not a good thing that the woman has…...

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References

Amir-Singh, J., Upshur, R., & Padayatchi, N. (2007). XDR-TB in South Africa: No Time for Denial or Complacency. Plos Med, 4(1), e50.  http://dx.doi.org/10.1371/journal.pmed.0040050 

Armbruster, B., & Brandea, M. (2007). Contact tracing to control infectious disease: when enough is enough. Health Care Management Science, 10(4), 341. Retrieved from  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3428220/ 

Boskey, E. (2016). Contact tracing really is an important thing to participate in.. About.com Health. Retrieved 20 March 2016, from  http://std.about.com/od/prevention/f/contacttracing.htm 

McKay, B. (2016). Dangerous TB Patient Detained on U.S. Border. WSJ. Retrieved 20 March 2016, from  http://www.wsj.com/articles/SB10001424127887323978104578332461533970412

A newer and easy test is the OSOM Vlue, which mixes a swabbed specimen from the vagina with a reagent. The test yields sialidase activity or presence in the vaginal fluid in 10 minutes. Sialidase is produced by V pathogens (Mashburn).
pH Level

The most reliable criterion for detecting V is a pH>4.5 (Mashburn, 2007). A normal pH should, therefore, rule out V. A pH >4.5 can also indicate trichomoniasis or muco-purulent cervicitis. Vaginal inflammation more strongly suggests trichomonas or muco-purulent cervicitis, in turn associated with gonorrhea or chlamydial trachomatis (Mashburn).

The patient's pH level is 6, indicating V.

Wet Smears

These are an inexpensive and relatively easy screening procedure for the most common sexually transmitted diseases, such as V (Iglesias, Alderman & Fox, 2000). The practitioner should be appropriately trained and experienced in using this procedure. Hence, the proper protocol and quality control are needed to insure accurate diagnosis. The wet smear is…...

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BIBLIOGRAPHY

Alfonsi, G.A.; Cshlay, J., and Parker, S. (2004). What is the best approach for managing

Recurrent bacterial vaginosis? Journal of Family Practice: Dowden Health Media,

Inc. Retrieved on July 7, 2009 from  http://findarticles.com/p/articles/mi_m0689/is_8_53/ai_n6169486/?tag=content;col1 

Brown, M (2007). Treating a case of bacterial vaginosis -- case study. Health and Republic News: Health Republic. Retrieved on July 12, 2009 from  http://www.healthcarerepublic.com/res/clinical/article/572868/treating-case-bacterial-vaginosis

ahrq.gov/clinic/uspstfix.htm, through the National Guideline Clearinghouse at http://www.guideline.gov.
Evidence-based findings concerning chlamydia screening and treatment of PID contained in the peer-reviewed and scholarly literature.

The additional resources cited at Appendix a will also be consulted.

3. Identify a specific group of people that are being affected by the disease/condition. The screening guidelines published by the USPSTF recommend that the following specific groups of women should be routinely screened, whether or not they are pregnant, if they:

Are sexually active and aged 25 or younger;

Have more than one sexual partner, regardless of age;

Have had an STD in the past, regardless of age; and Do not use condoms consistently and correctly, regardless of age (Screening for Chlamydial infection) a. Explain any unhealthy behaviors that may be contributing to the disease/condition. Some of the unhealthy behaviors that may contribute to the incidence of PID include (1) having multiple sex partners and (2) not using condoms consistently and…...

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Works Cited

Hubacher, D., R. Lara-Ricalde, D.J. Taylor, F. Guerra-Infante and R. Guzman-Rodriguez. (2001). "Use of copper intrauterine devices and the risk of tubal infertility among nulligravid women. New England Journal of Medicine 345: 561-67 in Mckay at 259.

Klein, Rupert and Barbel Knauper. (2003). "The Role of Cognitive Avoidance of STIs for Discussing Safer Sex Practices and for Condom Use Consistency." The Canadian Journal of Human Sexuality 12(3-4): 137-138.

Macdonald, Noni E. And Robert Brunham. (1997). "The Effects of Undetected and Untreated Sexually Transmitted Diseases: Pelvic Inflammatory Disease and Ectopic Pregnancy in Canada." The Canadian Journal of Human Sexuality 6(2): 161.

Mcglynn, Elizabeth a., Eve a. Kerr, Cheryl L. Damberg and Steven M. Asch. Quality of Care for Women: A Review of Selected Clinical Conditions and Quality Indicators. Santa Monica, CA: Rand, 2000.

Pelvic inflammatoy disease, a citical poblem
Occuence o ecuence of pelvic inflammatoy disease o PID has been linked to STIs such as C. tachomatis o Neisseia gonohoeae. Patient education and simplified guidelines ae needed to develop accuate diagnosis. In ode fo changes to take place, moe eseach must be done to undestand the complex natue of the disease and the most effective and cost effective method of teatment.

This pape delves into the isk factos, diagnosis pocesses, teatment, elevant psychological issues, public health implications, patient and family education, and appopiate efeal to specialty by eviewing liteatue petinent to PID. The esults of the liteatue eview show vey little in the past was done in egads to eseaching symptoms of PID and teatment efficacy. New eseach shows lowe abdominal pain as a main indicato of PID as well as C. tachomatis o Neisseia gonohoeae. The data also elaboates on the isks of…...

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references for fertility in women with pelvic inflammatory disease. Fertility and Sterility, 81(5), 1344-1350.

Sweet, R.L. (2011). Treatment of Acute Pelvic Inftammatory Disease. Infectious Diseases in Obstetrics and Gynecology, 2011(561909), 1-13.

Tepper, N.K., Steenland, M.W., Gaffield, M.E., Marchbanks, P.A., & Curtis, K.M. (2013). Retention of intrauterine devices in women who acquire pelvic inflammatory disease: a systematic review. Contraception, 5(87), 655-60. Retrieved from  http://www.ncbi.nlm.nih.gov/pubmed/23040135

Community Health Statistics for Caddo Parish, Louisiana
Description of Caddo Parish, Louisiana

With about a quarter of a million residents, Caddo Parish, Louisiana is a fairly older community with almost two-thirds of its population aged 25 years or older. Most of the residents of Caddo Parish (82.3%) are high school graduate or higher and 22.3% have a bachelor's degree or higher compared to the national averages of 84.6% and 27.5%, respectively. There are slightly more females than males in Caddo Parish, and median family incomes are slightly lower than the national average at $48,522; per capita income is also slightly less than the national average at $22,323. There are also slightly more whites than blacks (50.3% compared to 46.4%, respectively) in Caddo Parish. ecent relevant statistical data for these and other areas of interest are presented below.

Table

Biophysical Considerations: Caddo Parish

Population Size

Census

Pop.

5,282

8,884

68.2%

12,140

36.7%

21,714

78.9%

26,296

21.1%

Population Size

Census

Pop.

31,555

20.0%

1900

44,499

41.0%

1910

58,200

30.8%

1920

83,265

43.1%

1930

124,670

49.7%

1940

150,203

20.5%

1950

176,547

17.5%

1960

223,859

26.8%

1970

230,184

2.8%

1980

252,358

9.6%

1990

248,253

1.6%

2000

252,161

1.6%

2006

253,118

0.4% (estimate)

Source: Caddo Parish Census Data, United States Census Bureau. "Louisiana…...

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References

About the Parish of Caddo. (2011). Caddo Parish Official Web Site. Retrieved from http://

www.caddo.org/about.cfm/.

Annual report. (2007, 2010). Caddo Parish Official Web Site. Retrieved from http://www.caddo.

org/pdfs/.

prokaryotes consist of millions of genetically distinct unicellular organisms. A procaryotic cell has five essential structural components: a genome (DNA), ribosomes, cell membrane, cell wall, and some sort of surface layer which may or may not be an inherent part of the wall (1). Functional aspects of procaryotic cells are related directly to the structure and organization of the macromolecules in their cell make-up, i.e., DNA, RNA, phospholipids, proteins and polysaccharides. Diversity within the primary structure of these molecules accounts for the diversity that exists among procaryotes (1). Identifiable groups of prokaryotes are assembled based on easily observed phenotypic characteristics such as Gram stain, morphology (rods, cocci, etc.), motility, structural features (e.g. spores, filaments, sheaths, appendages, etc.), and on distinguishing physiological features (e.g. anoxygenic photosynthesis, anaerobiasis, methanogenesis, lithotrophy, etc.). Prokaryotes are commonly known as bacteria, and it is estimated that bacteria have been around for at least 3.5 billion…...

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BIBLIOGRAPHY

1. Bergey's Manual of Systematic Bacteriology (2nd Edition). 1989. Williams, S.T., Sharpe, M.E., Holt J.G. Lippincott Williams & Wilkins

2. Breiman RF, Butler JC, Tenover FC, Elliott JA, Facklam RR. (1994). Emergence of drug-resistant pneumococcal infections in the United States. JAMA. 1994 Jun 15;271(23):1831-5.

3. Center for Disease Control and Prevention. Antibiotic/Antimicrobial resistance.  http://www.cdc.gov /drugresistance/actionplan/html/

4. Jones RN, Pfaller MA (1998). Bacterial resistance: a worldwide problem. Diagn Microbiol Infect Dis. Jun;31(2):379-88.

" (ean, 2006) ean notes that a "dramatic decline in the influence of father involvement has been shown to be correlated with fathers' maintaining a residence other than that of their children." (2006)
According to the work entitled: "Theoretical Models of Juvenile Delinquency" developmental pathways of adolescent delinquency has been examined by researcher "through both longitudinal research and meta-analyses." (Theoretical Models of Juvenile Delinquency, nd) Resulting from these empirical investigations are "numerous insights...key indicators and predictors of behavior of those youths who engage and those who persist in delinquent behavior." (Theoretical Models of Juvenile Delinquency, nd) According to this work there have been a number of studies which had made identification of characteristic patterns of parent-child relationships that are strongly associated with juvenile delinquency." (Theoretical Models of Juvenile Delinquency, nd) the work of Juby and Farrington (2001); Patterson and Stouthamer-Loeber (1984); and Steinberg (1987) state that "evidence clearly demonstrates the influence…...

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Bibliography

Allen, Sarah; and Daly, Kerry (2007) the Effects of Father Involvement: An Updated Research Summary of the Evidence Inventory. FIRA-CURA Centre for Families, Work & Well-Being University of Guelph, Ontario Canada. Online available at   ts/29/Effects_of_Father_Involvement.pdf+CORRELATION+BETW EEN+the+ABSENCE+of+PATERNAL+INVOLVEMENT+and+SEXUAL+RISK+TAKING+BEHAVIOR+in+ADOLESCENT+FEMALES&hl=en&ct=clnk&cd=26&gl=ushttp://64.233.169.104/search?q=cache:9pJUiihSv0YJ:fira.ca/cms/documen 

Bean, Matthew (2006) Understanding Father's Roles: An Evidence-Based Practice Guide for Family Therapists. Kansas State University 2006. Online available at  http://64.233.169.104/search?q=cache:R_K1C-afXJ8J:krex.k-state.edu/dspace/bitstream/2097/314/1/MatthewBean2007.pdf+CORRELATION+BETWEEN+the+ABSENCE+of+PATERNAL+INVOLVEMENT+and+SEXUAL+RISK+TAKING+BEHAVIOR+in+ADOLESCENT+FEMALES&hl=en&ct=clnk&cd=37&gl=us 

Brooks, Constance M. (2007) Environmental Risk Factors and Risky Sexual Behavior Outcomes: Attitudes as a Mediating Factor. Online available at http://edt.missouri.edu/Winter2007/Dissertation/BrooksC-051107-D6584/research.pdf

Duncan, G.J., & Brooks-Gunn, J. (Eds.) (1997). Consequences of growing up poor. New York: Russell Sage Foundation Brooks, Constance M. (2007) Environmental Risk Factors and Risky Sexual Behavior Outcomes: Attitudes as a Mediating Factor. Online available at http://edt.missouri.edu/Winter2007/Dissertation/BrooksC-051107-D6584/research.pdf

Tipping Point by Malcolm Gladwell
The Tipping Point: How Little Things Can Make a Big Difference is a book about epidemics. However, Gladwell is not writing about diseases. He is writing about how the behaviors and attitudes of a population change in much the way an epidemic spreads. As Gladwell describes, only one child has to go to school with measles. The next week, almost every child at the school can have measles. It only took one change in this one child to make a significant difference. This situation where seemingly small changes make big differences is the focus of the book. Gladwell uses the metaphor of a spreading virus to explain how ideas, products, messages, and behaviors can all spread in the same way. He explains how something can suddenly become an accepted fashion item, how people's behavior can change on a mass scale, how information can spread via…...

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Works Cited

Gladwell, M. The Tipping Point: How Little Things Can Make a Big Difference. New York: Back Bay Books, 2004.

A dominant healthcare practice for many Mexican-Americans is the hot and cold theory of food selection, where illness or trauma may require adjustments in the hot and cold balance of foods to restore body equilibrium. In lower socioeconomic groups is a wide-scale deficiency of vitamin a and iron, as well as lactose intolerance.
Mexican-American birth rates are 3.45 per household compared to 2.6 per household among other minority groups (Chapa & Valencia, 1993 as cited in Purnell & Paulanka, 1998). Multiple births are common, particularly in the economically disadvantaged groups. Men see a larger number of children as evidence of their virility. If a woman does not conceive by the age of 24, it may be considered too late. Given their predominant Catholic beliefs, the tendency is only to use acceptable forms of birth control, although many will use other unacceptable forms. Abortion is morally wrong. Family planning is an…...

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References Cited:

Lopez, P. (2003) Mexican-American Health Issues for the 21st Century. Californian Journal of National Institute of Child Health and Human Development (2000) Health Disparities: Bridging the Gap. Washington: U.S. Department of Health and Human Services.

Purnell, L, & Paulanka, B. (1998). Transcultural Healthcare. Philadelphia: Davis Company.

Purnell, L. & Paulanka, B. (1998a) Purnell Model for Cultural Competence. in

Nava, G. (director) Quintanilla, a. (executive producer) (1997) Selena. Q Productions.

In addition the Europeans that colonized Australia believed that their culture was superior and the aboriginal culture would somehow disappear in a short period of time. hen this did not occur drastic steps were taken to assimilate indigenous people. These steps included taking aboriginal children away from their families to be raised in white society.
Certainly this type of violent and reckless interaction led to great fear and panic because a way of life that had existed for thousands of years began to vanish. Such stressors were passed down from generation to generation. Stress is a dangerous emotion because it can cripple to immune system and also cause people not to have the will to properly take care of their health.

Government policy and exclusion

According to McCalman et al. (2005) the types of government policies adapted as a result o colonialism has also contributed to poor health amongst indigenous groups when…...

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Works Cited

Aboriginal health issues.  http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/aboriginal_health_issues-open 

Anderson, I.,&Whyte, D. (2006). Australian Federalism and Aboriginal Health. Australian Aboriginal Studies, 2, 5-16.

McCalman, J., Morley, R., & Mishra, G. (2008). A health transition: Birth weights, households and survival in an Australian working class population sample born 1857 -- 1900. Social Science & Medicine, 66, 1070-1083.

McCalman J., Smith L., Anderson I., Morley R., Mishra G. (2009) Colonialism and the health transition: Aboriginal Australians and poor whites compared, Victoria, 1850 -- 1985. History of the Family 14-253 -- 265

Mary Jane's laboratory results show there is an elevated white blood count, with CBC with differential within normal limits. Proton and INR were normal. Pregnancy was negative. UA showed occasional bacteria, but normal otherwise. Drug screen was normal, and EKG showed sinus bradycardia, rate of 59 beats per minute. Renal and hepatic functions were within normal limits.

There are four sexual response cycles, marked by physiological and psychological changes. The first stages is excitement, which Mary Jane is not getting with her partners, which is triggered by psychological or physical stimulation, and is marked by emotional changes, and increased heart rate, and vaginal swelling. Second stage is plateau, Mary Jane states she doesn't have this stimulation. The third stage is orgasm, which Mary Jane doesn't getting during intercourse, or she doesn't remember because she in under the influence of alcohol. The final phase, resolution, involves a rush of blood away from…...

In the studies quoted herein the numbers show evidence that blacks suffer a much higher rate of incidence than do whites or Latinos, and that black women suffer a much higher rate when compared against their white counterparts and they are a significant percentage of the overall rate of incidence in both Baltimore and the United States. There is not much potential in numbers for a bias, after all, they are what they are. The number of incidences reported can only be interpreted as being either a person of African-American descent, white heritage or Latino in nature. ith numbers there can hardly be any quibbling back and forth, especially when the numbers are as lopsided as they are in this paper.
Analysis

The answer to the question of whether culture affects the incidence of AIDS/HIV infection seems to be numerically clear, in that the statistics show that in Baltimore and across…...

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Works Cited

Brown, G. (2003) HIV / AIDS among African-Americans and U.S. women: Minority and young women, Minority Nurse Newsletter, Fall Issue 2003

Elder, M.C. (1999) AIDS conference addresses African-American AIDS epidemic, New York Amsterdam News, Vol. 90, Issue 36

Ferguson, Y.O.; Quinn, S.C.; Eng, E.; Sandelowski, M.; (2006) the gender ratio imbalance and its relationship to risk of HIV / AIDS among African-American women at historically black colleges and universities, AIDS Care, Vol. 18, Issue, 4, pp. 323-331

More women infected by AIDS virus (1994) Futurist, Vol. 28, Issue 2, p. 62

Using condoms is also an excellent prevention activity that can also be used (Primary and Secondary HIV Prevention, 2008).
Potential obstacles to HIV prevention activities taking place in clinical settings often include:

narrow formations of medical care and the role of physicians or health care providers in HIV prevention, a provider's discomfort with discussing human sexuality and illicit drug use and their attitudes towards persons with HIV or AIDS along with constraints on time and resources, and the vagueness of HIV prevention messages (Primary and Secondary HIV Prevention, 2008).

The very nature of HIV transmission involves behaviors that are not readily discussed in American society. It is important for health care providers to become comfortable discussing sexual and substance-use activities with their patients. They need to create an environment of trust for patients so their risk behaviors can be discussed. It is important to assure the patient of the confidential nature of…...

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References

ABCs of Aids Prevention - Presentation Transcript. (2009). Retrieved September 3, 2009, from Slideshare Web site:  http://www.slideshare.net/drsujnanendra/ab-cs-of-aids-prevention 

CDC Responds to HIV / AIDS. (2009). Retrieved from Centers for Disease Control and Prevention

Web site:  http://www.cdc.gov /hiv/aboutDHAP.htm

HIV / AIDS. (2009). Retrieved September 4, 2009, from MayClinic Web site: