Myasthenia Gravis: A Case Study

Evaluation will be performed utilizing the Rapid Critical Appraisal Checklist for Evidence-Based Clinical Practice Guidelines (Slutsky, 2005) and use of the National Guideline Clearinghouse (NCG), guideline summary (2016).

Over the years medical providers have come to realize that some treatments and screenings are more appropriate than others for diseases and/or illnesses. As this occurs these successful findings are published and then become the gold standard by which providers treat patients. Without these gold standard practices treatment is fragmented and can fail. In light of this knowledge the government began a website to gather these guidelines and recommendations in one simple place for providers to access no matter their location. The Agency for Healthcare Research and Quality is a part of the US Department of Health and Human Services and this is where providers can find those recommendations and guidelines thus improving patient outcomes by utilizing them.

any kind of self treatment. Do not administer any dose of mentioned drugs in this reference guide without

NICE (2014) defines its clinical guidelines as recommendations, which are systematically-developed, on how healthcare professionals should care for a condition or conditions of patient. On the best available evidence, these recommendations are based (NICE 2014). Grol (2010) emphasizes the fact that to improve patient care, efforts are being made on evidence-based guidance, which is one way to do this. NICE guidelines are developed with methodological rigour using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument (Rapu & Matthews 2014). This instrument was designed as to assess, across the spectrum of health, the quality of practice guidelines (Brouwers et al. 2010). Furthermore, it provides guideline development directions and gives information that should be contained in guidelines (Brouwers et al. 2010). Established above, it provides a structure

Summaries – Evidence is taken from practice guidelines that were established by healthcare organizations and entered into the National Guidelines Clearinghouse databases. Summaries can be appraised rapidly because they are given a

With any medication prescribed it is the duty of the prescriber an any mental health professional working directly with that client to provide them with as much psychoeducation as possible. It is vital that the client understands the benefits and risks of the medication. FUrthermore, it is vital for the client to understand that the client must be willing to commit to the process of finding the correct cocktail if you will.

Damage to the neuromuscular junctions is due to an autoimmune disease called myasthenia graves. The motor end plates, which are located on skeletal muscles, are affected because there is a decrease in the amount of Ach receptors located on the motor end plate, which is connected to the neuromuscular junction. The decrease is due to the unnecessary production of antibodies, which bind to the motor end plate. This prevents Ach from binding to the receptors to carry out a synapse between the skeletal muscle and a neuron, leading to a stop or weakening of muscle contraction. The decrease in the amounts of synapses cause the skeletal muscle to lose function, become weaker, and tire more easily.

It synthesizes the results of various primary studies by using strategies that reduces biases and random errors. These reviews follow a strict scientific design and provide consistent estimates about the effects of interventions, therefore, conclusions are defensible. Systematic reviews shows where knowledge is lacking and can be used to guide future research. These reviews are usually carried out in the areas of clinical tests such as diagnostic, screening and prognostic; public health interventions; economic evaluations; adverse effects and how and why interventions work. Cochrane reviews are systematic reviews undertaken by Cochrane Collaboration members, aims to help people to make well-informed decisions about healthcare by preparing, maintaining, and promoting the accessibility of systematic reviews of the effects of healthcare

The author considers the simplest way of finding out best practice is by using guidelines. According to Field & Lohr (1992) guidelines are “systematic developed statements to assist practitioners and patients decisions for specific clinical circumstances.” Evidence is always current and a generous collection of many different systematic research reviews with multiple random control trials are available (AGREE, 2000). These types of trials are graded at the top level of hierarchy (Guyatt et al 2002).Nevertheless in contrast Devereaux and Yusuf (2005) argue that top level hierarchy is not a guaranteed deviation from the truth in randomized trials. The clinical guidance used is the National Institute of Clinical Guidance (NICE 2009) is based in the author’s homeland and is an independent organisation responsible for providing guidelines. The ethos behind NICE (2009) is to promote and prevent poor health nationally involving the public, health professionals and patients in the process (NICE 2009).

The idea of reporting the news is to tell viewers what is happening in the world without bias and from a neutral standpoint. Over the years, however, some things slip through the cracks and news is reported biasly, especially in racial terms. There are many solutions to remedy this situation by keeping equal representation within reporters and reporting fairly on all platforms. New policies can be put in place as not censorship but purely unbiased reports and news articles to prevent outrage and possibly boost ratings.

The indication and choice of medications for prevention of relapse in patients with medically induced remission should take into account three main factors: the course of the disease (initial presentation, frequency, and severity of flares); the effectiveness and tolerance of treatments previously used for induction of remission or maintenance and the extent of disease. Other factors, such as the presence of biological signs of inflammation and smoking status, should also be considered, as well as constraints (logistic, social, or financial) affecting the choice of treatment. Patients should be encouraged to participate in the decision-making process. After the first presentation if remission has been achieved medically, maintenance with mesalazine

While there is no medication which relieves every symptom of TS, there is the possibility of improvement if the patient does not have serious side effects to the medications, of which there are a variety (i.e. pimozide, risperidone, clonidine) (8). Researches have found that the drug haloperidol acts on dopamine and in turn calms the patient. Haloperidol works by blocking the receiving areas on receptor cells where dopamine passes on messages

must be used with therapy because it has been found that neither the drugs or therapy is enough by themselves.

Kabuki - Kabuki is a style of Japanese theater that evolved from Noh theater. Noh was slow, contemplative, and philosophical, and eventually became so refined that it was considered inaccessible and reserved for the educated upper classes. Kabuki was developed by the rising middle class as popular entertainment, and included stylized fighting, aerial stunts, exaggerated makeup and costuming, and physical and verbal comedy.

China has had the new population control for almost 36 years, composed by the one-child policy and prohibited excess reproduction. The birth control plan has received praise on reducing the population, but also received criticism over the late 20th century. In 1979, couples were forced to pledge not to give second birth or bear any more children (Feng, 2014). From 1979 to 2015, while the population growth rate has reduced substantially, this implementation has been tremendously restructured how Chinese families value family structure, child preferences, marriage, parenting, living arrangements, and eldercare. This one child policy has transformed into a problematic system for the Chinese family to maintain their traditional value, and also introduced new problems to the family.