Friday 17 April 2015

                  Medical-surgical nursing

From Wikipedia, the free encyclopedia
Medical-surgical nursing is a nursing specialty area concerned with the care of adult patients in a broad range of settings. The Academy of Medical-Surgical Nurses (AMSN) is a specialty nursing organization dedicated to nurturing medical-surgical nurses as they advance their careers. Traditionally, medical-surgical nursing was an entry-level position that most nurses viewed as a stepping stone to specialty areas. Medical-surgical nursing is the largest group of professionals in the field of nursing. Advances in medicine and nursing have resulted in medical-surgical nursing evolving into its own specialty.
Many years ago a majority of hospital nurses worked on wards, and everyone was a medical-surgical nurse. Today licensed medical-surgical nurses work in a variety of positions, inpatient clinics, emergency departments, HMO’s, administration, out patient surgical centers, home health care, humanitarian relief workambulatory surgical care, and skilled nursing homes. Some military medical-surgical nurses serve on battlefields.
Registered nurses can become certified medical-surgical nurses through the American Nurses Credentialing Center.

Medical-surgical nursing

Medical-surgical nursing is a nursing specialty area concerned with the care of adult patients in a broad range of settings. The Academy of Medical-Surgical Nurses (AMSN) is a specialty nursing organization dedicated to nurturing medical-surgical nurses as they advance their careers. Traditionally, medical-surgical nursing was an entry-level position that most nurses viewed as a stepping stone to specialty areas. Medical-surgical nursing is the largest group of professionals in the field of nursing. Advances in medicine and nursing have resulted in medical-surgical nursing evolving into its own specialty.[1][2]Many years ago a majority of hospital nurses worked on wards, and everyone was a medical-surgical nurse. Today licensed medical-surgical nurses work in a variety of positions, inpatient clinics, emergency departments, HMO’s, administration, out patient surgical centers, home health care, humanitarian relief workambulatory surgical care, and skilled nursing homes. Some military medical-surgical nurses serve on battlefields.Registered nurses can become certified medical-surgical nurses through the American Nurses Credentialing Center.

Thursday 16 April 2015

Overview

                        Medical librarians are an integral part of the health care team. They have a direct impact on the quality of patient care, by helping physicians, allied health professionals and researchers to stay abreast of new developments in their specialty areas. They also work closely with patients and consumers who are seeking authoritative health information.
Medical librarians often serve on the faculty of health care and biomedical degree programs, where they teach health care providers how to access and evaluate information and contribute expertise on a variety of topics. They also may serve on university or pharmaceutical company research teams, where they can have an impact on the development of new treatments, products and services.
Medical librarians provide access to resources in a variety of formats, ranging from traditional print to electronic sources and data. They design and manage websites, Internet blogs, distance education programs and digital libraries. They conduct outreach programs to public health departments, consumers, off-site students and unaffiliated healthcare providers.
Medical librarians work closely with a variety of personnel within the library to accomplish day-to-day tasks. They also collaborate with colleagues in a variety of institutional tasks, such as fundraising, marketing, business and information technology systems.
Informationists, a new role for medical librarians, are experts with training in both information science and clinical/biomedical science. They retrieve and synthesize information and work in clinical or research settings. 

Working Conditions

                                              Medical librarians are employed anywhere health information is needed. Employment settings include colleges, universities and professional schools; hospitals, academic health centers and clinics; consumer health libraries; research centers; foundations; biotechnology centers; insurance companies; medical equipment manufacturers; pharmaceutical companies; publishers; and federal, state and local government agencies.
Some medical librarians work in non-traditional library settings such as Internet companies, where they select, index and organize information on the Web. Others are directors of large hospital or academic health center libraries. They often serve as chief information officers for health care organizations. In academic settings, medical librarians tend to hold positions of broad responsibility and high visibility -- i.e., as associate university librarians, deans or associate deans.
As with other healthcare professions, a high percentage (50%) of medical librarians will be retiring over the next 10 years. This creates a positive job market with a wide variety of available positions.
Salaries vary according to the type and location of the institution, level of responsibility and technical skill and length of employment. According to the Medical Library Association, the starting salary is over $40,000/year, and the average is close to $65,000. Library directors earn up to $158,000.

Antioxidant

From Wikipedia, the free encyclopedia
Model of the antioxidant metaboliteglutathione. The yellow sphere is the redox-active sulfur atom that provides antioxidant activity, while the red, blue, white, and dark grey spheres represent oxygen, nitrogen, hydrogen, and carbon atoms, respectively.
An antioxidant is a molecule that inhibits the oxidation of other molecules. Oxidation is a chemical reaction involving the loss of electrons or an increase in oxidation state. Oxidation reactions can produce free radicals. In turn, these radicals can start chain reactions. When the chain reaction occurs in a cell, it can cause damage or death to the cell. Antioxidants terminate these chain reactions by removing free radical intermediates, and inhibit other oxidation reactions. They do this by being oxidized themselves, so antioxidants are often reducing agents such as thiols,ascorbic acid, or polyphenols.[1]
Substituted phenols and derivatives ofphenylenediamine are common antioxidants used to inhibit gum formation in gasoline (petrol).
Although oxidation reactions are crucial for life, they can also be damaging; plants and animals maintain complex systems of multiple types of antioxidants, such as glutathionevitamin Cvitamin A, and vitamin E as well as enzymes such as catalasesuperoxide dismutase and variousperoxidases. Insufficient levels of antioxidants, or inhibition of the antioxidant enzymes, cause oxidative stress and may damage or kill cells. Oxidative stress is damage to cell structure and cell function by overly reactive oxygen-containing molecules and chronic excessive inflammation. Oxidative stress seems to play a significant role in many human diseases, including cancers. The use of antioxidants in pharmacology is intensively studied, particularly as treatments for stroke and neurodegenerative diseases. For these reasons, oxidative stress can be considered to be both the cause and the consequence of some diseases.
Antioxidants are widely used in dietary supplements and have been investigated for the prevention of diseases such as cancer, coronary heart disease and even altitude sickness.[2] Although initial studies suggested that antioxidant supplements might promote health, later large clinical trials of antioxidant supplements including beta-carotene, vitamin A, and vitamin E singly or in different combinations suggest that supplementation has no effect on mortality or possibly increases it.[3][4][5]Randomized clinical trials of antioxidants including beta carotene, vitamin E, vitamin C and selenium have shown no effect on cancer risk or increased cancer risk associated with supplementation.[6][7][8][9][10][11][12] Supplementation with selenium or vitamin E does not reduce the risk of cardiovascular disease.[13][14]
Antioxidants also have many industrial uses, such as preservatives in food and cosmetics and to prevent the degradation of rubber and gasoline.[15]

History[edit]

As part of their adaptation from marine life, terrestrial plants began producing non-marine antioxidants such as ascorbic acid (vitamin C), polyphenols and tocopherols. The evolution of angiosperm plants between 50 and 200 million years ago resulted in the development of many antioxidant pigments – particularly during the Jurassic period – as chemical defences against reactive oxygen species that are byproducts of photosynthesis.[16] Originally, the term antioxidant specifically referred to a chemical that prevented the consumption of oxygen. In the late 19th and early 20th centuries, extensive study concentrated on the use of antioxidants in important industrial processes, such as the prevention of metal corrosion, the vulcanization of rubber, and the polymerization of fuels in the fouling of internal combustion engines.[17]
Early research on the role of antioxidants in biology focused on their use in preventing the oxidation of unsaturated fats, which is the cause of rancidity.[18] Antioxidant activity could be measured simply by placing the fat in a closed container with oxygen and measuring the rate of oxygen consumption. However, it was the identification of vitamins A,C, and E as antioxidants that revolutionized the field and led to the realization of the importance of antioxidants in the biochemistry of living organisms.[19][20] The possible mechanisms of action of antioxidants were first explored when it was recognized that a substance with anti-oxidative activity is likely to be one that is itself readily oxidized.[21] Research into how vitamin E prevents the process of lipid peroxidation led to the identification of antioxidants as reducing agents that prevent oxidative reactions, often by scavenging reactive oxygen species before they can damage cells.[22]

Oxidative challenge in biology[edit]

Further information: Oxidative stress
The structure of the antioxidantvitamin ascorbic acid (vitamin C).
paradox in metabolism is that, while the vast majority of complex life on Earthrequires oxygen for its existence, oxygen is a highly reactive molecule that damages living organisms by producing reactive oxygen species.[23]Consequently, organisms contain a complex network of antioxidant metabolitesand enzymes that work together to prevent oxidative damage to cellular components such as DNAproteins and lipids.[1][24] In general, antioxidant systems either prevent these reactive species from being formed, or remove them before they can damage vital components of the cell.[1][23] However, reactive oxygen species also have useful cellular functions, such as redox signaling. Thus, the function of antioxidant systems is not to remove oxidants entirely, but instead to keep them at an optimum level.[25]
The reactive oxygen species produced in cells include hydrogen peroxide(H2O2), hypochlorous acid (HClO), and free radicals such as the hydroxyl radical (·OH) and the superoxide anion (O2).[26] The hydroxyl radical is particularly unstable and will react rapidly and non-specifically with most biological molecules. This species is produced from hydrogen peroxide in metal-catalyzedredox reactions such as the Fenton reaction.[27] These oxidants can damage cells by starting chemical chain reactions such as lipid peroxidation, or by oxidizing DNA or proteins.[1] Damage to DNA can cause mutations and possibly cancer, if not reversed by DNA repair mechanisms,[28][29] while damage to proteins causes enzyme inhibition, denaturation andprotein degradation.[30]
The use of oxygen as part of the process for generating metabolic energy produces reactive oxygen species.[31] In this process, the superoxide anion is produced as a by-product of several steps in the electron transport chain.[32]Particularly important is the reduction of coenzyme Q in complex III, since a highly reactive free radical is formed as an intermediate (Q·). This unstable intermediate can lead to electron "leakage", when electrons jump directly to oxygen and form the superoxide anion, instead of moving through the normal series of well-controlled reactions of the electron transport chain.[33] Peroxide is also produced from the oxidation of reduced flavoproteins, such as complex I.[34]However, although these enzymes can produce oxidants, the relative importance of the electron transfer chain to other processes that generate peroxide is unclear.[35][36] In plants, algae, and cyanobacteria, reactive oxygen species are also produced during photosynthesis,[37] particularly under conditions of high light intensity.[38] This effect is partly offset by the involvement of carotenoids in photoinhibition, and in algae and cyanobacteria, by large amount of iodideand selenium,[39] which involves these antioxidants reacting with over-reduced forms of the photosynthetic reaction centres to prevent the production of reactive oxygen species.[40][41]

Metabolites[edit]

Overview[edit]

Antioxidants are classified into two broad divisions, depending on whether they are soluble in water (hydrophilic) or in lipids (lipophilic). In general, water-soluble antioxidants react with oxidants in the cell cytosol and the blood plasma, while lipid-soluble antioxidants protect cell membranes from lipid peroxidation.[1] These compounds may be synthesized in the body or obtained from the diet.[24] The different antioxidants are present at a wide range of concentrations inbody fluids and tissues, with some such as glutathione or ubiquinone mostly present within cells, while others such asuric acid are more evenly distributed (see table below). Some antioxidants are only found in a few organisms and these compounds can be important in pathogens and can be virulence factors.[42]
The relative importance and interactions between these different antioxidants is a very complex question, with the various metabolites and enzyme systems having synergistic and interdependent effects on one another.[43][44] The action of one antioxidant may therefore depend on the proper function of other members of the antioxidant system.[24]The amount of protection provided by any one antioxidant will also depend on its concentration, its reactivity towards the particular reactive oxygen species being considered, and the status of the antioxidants with which it interacts.[24]
Some compounds contribute to antioxidant defense by chelating transition metals and preventing them from catalyzing the production of free radicals in the cell. Particularly important is the ability to sequester iron, which is the function ofiron-binding proteins such as transferrin and ferritin.[36] Selenium and zinc are commonly referred to as antioxidant nutrients, but these chemical elements have no antioxidant action themselves and are instead required for the activity of some antioxidant enzymes, as is discussed below.