Chronic Cough and Gastroesophageal Reflux Disease Research Paper

Incessant Cough and Gastroesophageal Reflux Disease - Research Paper Example Incessant hack in kids has been pervasive these days and as a rule this prompts much progressively genuine respiratory conditions. This point is imperative to the writer of this article in light of the fact that as a human services supplier it is a job of a medical attendant to maintain the soundness surprisingly particularly for individuals who are insusceptible denied, for example, in little youngsters. On an individual perception and as per considers, respiratory ailments are one of the most widely recognized reasons for hospitalization in kids. One can tell just by going into the pediatric branch of a medical clinic and perusing over the reasons for their hospitalization and the most elevated likelihood is that regularly ceaseless hack is consistently one of the causes. With this investigation is a would like to build up the relationship of ceaseless hack, one of the most widely recognized reason for mortality in kids, and GERD that could help in the best possible determination a nd just as legitimate treatment to forestall further entanglements. This is ideal and significant particularly for pediatric clinicians to help them in appropriately diagnosing interminable hack that may be expected to gastro-esophageal reflux illness and guide them in rewarding such conditions if the relationship be set up appropriately by investigates. What's more, most particularly the endpoint supporter would be the pediatric patients and their folks in light of the fact that setting up the relationship may wind up the high pervasiveness of interminable hack and kids just as hospitalization. This will set aside patients time and cash because of unessential diagnostics.

Why Wait for Tomorrow Why Not Now Free Essays

This article â€Å"More Testing More Learning† is composed by Patrick O’ Malley. In this article O’ Malley is discussing how to make an understudies learning more effectively than it is. The word all the more testing and all the more learning imply that in the event that we test increasingly, at that point it makes simpler for us to learn and see more. We will compose a custom exposition test on Why Wait for Tomorrow? Why Not Now? or then again any comparable subject just for you Request Now In this section Patrick says that understudies today are so languid to concentrate on schedule, they possibly study when their midterms or finals are close, which gets them stressed over their investigations. He said that on the off chance that one understudy have C in his midterm, at that point he feels that last is the main possibility for him to overcome his class or it could break him and he could flung in it. O’ Malley has given astonishing recommendations in this article which could improve students’ scholarly and will be useful for him to learn better. O’ Malley has a solid point, that if instructors could give more in class tests or tests after each part or toward the finish of each section, at that point it would be useful for its understudy and will improve in understudies instructive information. It’s genuine that instruction has consistently had a significant influence in our lives, however concentrating without seeing ever encourages one in its expert life. We have seen a great deal of understudies including myself like to examine a night prior to our tests, which could give us an aftereffect of a disappointment. Our outcomes depend on our learning power, and on the off chance that our learning power is lesser, at that point the course material then it will cause us to feel as though we are in a tough situation. The issue isn't that we are in a tough situation of bombing the course or getting dropped from class since we can’t make it, however the issue is that our instructors ought to support us and make our course simpler for us to comprehend. By what means can an instructor do that? As O’ Malley said by give student’s in-class tests, tests after each section or part of study, and offer assignments to do, with the goal that the two of them realize how frail understudy is specifically subject. Taking these sorts of tests all the more as often as possible will urge understudy to change its propensity, and build up its learning abilities. At the other hand according to the contention goes on between teachers that a regular test appears to make more issues, in this manner there are numerous other substitute situations to accomplish similar standards. Initial one is to present a program which will chip away at improving understudies study aptitudes. While this program should show an understudy how to be set up for tests, besides this may won’t be useful in disposing of that stress and uneasiness, yet it will get past them. The subsequent situation is to give them in class inquiries to do. These inquiries will assist them with chipping away at their planning. Like for a model, if instructor is clarifying a section on in present class and pose them a few inquiries about that specific part so as to do an amendment in next class will help them improving their planning for comprehension and remembering the course material for a major test. Presently the third and last situation is about how to help understudy in arrangement of their midterm and end of the year tests. Before the two tests educator ought to furnish understudies with a type of a supposition paper. Like giving a few inquiries and thought of what is coming in test and where it is coming from, so it will be simpler for an understudy to learn, in light of the fact that they realize what is coming test and from where. Additional testing causes us to find out additional. Everybody has their own particular manners to learn, some do it simultaneously on same day and some postpone them until their tests. On the off chance that I would need to contrast myself with this article I would more probable say that I come in understudies who holds up until their tests are close. I have consistently concurred with the possibility that if educator will make learning simpler for us by giving us in class tests, tests, by posing a few inquiries on a day or two ago of class to see that if understudy recollects what they realize in past class, or by instructor giving an example test or they mention to us what is coming in test and what isn't. These all thoughts make it simpler for me it has consistently worked. I despite everything do have some instructor in present and past classes who consistently made it simple for me like my introduction to business and music class educators in last semester, and English and PC data educator in present semester. At long last I might want to state that instructors do help, they generally do, yet it relies upon us how regularly we comprehend and realize what is best for us to improve our abilities. Like I said before that the facts demonstrate that training is assuming a significant job in our life, yet what’s the utilization of that sort of instruction wherein we simply figure out how to dispose of it. As a vital saying by an individual to individual â€Å"Study what you like, study what you are acceptable at, yet concentrate by understanding it not by disposing of it†. How to refer to Why Wait for Tomorrow? Why Not Now?, Papers

A way a lone a last a loved a long the

A way a lone a last a loved a long the This weekend I went on a rafting trip down the Kennebec river in mid-to-Northern Maine with some people from my dorm. The Edwards Dam apparently didnt do much for the rainbow smelt population in the river, but it did make for some pretty nice class 4 rapids on the upper part of the river. We had about 36 people go, we slept in cabins, we swam, we played Mafia, and we saw the aurora borealis. Im a little too sleepy to blog about all of it tonight, so Ill leave you with this moral dilemma: On the way home, we stopped at a Wendys. I ordered a #5 Spicy Chicken Fillet combo. However, I was served a #4 Big Bacon Classic combo with mayonnaise and pickles. Now, as you can see, the actual nutritional difference between the two sandwiches was pretty much negligible; however, I really wanted some poultry, so I took the hamburger and my receipt back up and asked for a chicken sandwich. The cashier gave me a chicken sandwich, then took the hamburger, took it behind the counter, and threw it out. I understand that this should be company policy, since I had already handled the food and it was no longer saleable, but stillwouldnt it have been better to give the defective hamburger back to me rather than immediately disposing of it? Anyway, my dormmates and I had a passionate discussion about it on the bus, and then I called Mitra to settle things from an economic perspective. So, as I see it, these are the two main arguments: A: I shouldnt get the hamburger, because I didnt pay for it. B: I should get the hamburger, because they were going to throw it out anyway, so what does it matter whether it goes in the trash or into the mouth of somebody I know? What do you guys think? And have any of you actually worked at a fast food establishment? Is there a logical reason for this throw-out-the-bad-food policy that Im just missing because of my blinding love for Wendys spicy chicken? Anyway, until the matter is resolved Im boycotting Wendys, and I would encourage you to join me. Maybe, if Im so motivated, Ill write a letter to Wendy herself asking for an apology. Then, and only then, will I be able to enjoy in good conscience those tender, flaky, tangy sandwiches once more. Oh yeah. Yeah, so tomorrow actual rafting!

The Australian Security Intelligence Organization

My future is indefinite, and I can only attempt to improve it day by day. However, once you have your vision set out, you can take the steps towards your future, and become successful in anything that you set your mind to. Learning is a big part of growing and with the right mind frame and fruitfulness, the knowledge you attain in your everyday life will guide you towards a potential industry that you aspire to be involved in. Once you have knowledge, you can acquire a passion and that will be a constant drive towards your goals. A passion that I have recognised in myself lies in the industry of Public Administration and Safety. To be more concise the sector that I will be focusing on within this industry is The Australian Security†¦show more content†¦From past censuses it confirms that the expansion rate of employment in this sector is above the nation’s average in relation to all industries. Therefore, it is quite observable that this industry provides abundant opportunity for individuals in the Australian community seeking employment. Depending on which sector you are employed in, this will determine your role. Eight sectors can be classified from public administration and safety and those are; â€Å"Defence, Justice, Regulatory Services, Central Government Administration, Public Order Safety Services, State Government Administration, Local Government Administration and Government Representation† (My career match, 2012). Contributions to society are endless, since the roles can be towards defence, or local community protection, with this in mind majority of the government workers tend to be passionate towards the idea of promoting the nations interests in their workplace. In doing so it creates a connection of organisations that systematically work together. The industries broadness presents the opportunity for me to analyse my chosen career more thoroughly, in relation to an ASIO career I believe every day the job involves analysing and reporting prospective t hreats. Resulting in a production of protective security measures, in which Australia’s communities, people and assets are safe. From the words of Pietsch and McAlister â€Å"Australia has been

Hond An Analysis Of Honda Motor Corporation Limited

Honda – An analysis Introduction: Honda Motor Corporation limited is a Japanese public Multinational Company headquartered in Tokyo, Japan. It is well known for manufacturing motorcycles, automobiles, power products and financial services. The company is world’s largest motorcycle manufacturers and one of the top ten automakers. The company has a network of 365 subsidiaries and 83 affiliates. Honda has thirty-five assembly plants across the world. Out of which seven are in North America, four in South America, fifteen plants in Asia/Oceania, seven in china, five in Europe/Middle East/Africa and nine in Japan. (Honda, n.d.) It was established in September 1948 by Soichiro Honda and Takeo Fujisawa under the basic principle of â€Å"The Respect for Individual† and â€Å"The Three Joys† expressed as â€Å"The Joy of Buying†, â€Å"The joy of Selling† and â€Å"The Joy of Creating†. The company has developed a decentralized organizational structure. (Honda, n.d.) Fig1. Depicts level of higher hierarchy at Honda (Honda, n.d.) From table 1, Fumihiko Ike is the Chairman of the company. Takanobu Ito and Tetsuo Iwamura are President and Vice President respectively. Nobuo Kuroyanagi and Hideko kunii are designated as outside directors in accordance to Article 2, Item 15 of the Company Law. Takashi Yamamoto and Yoshiharu Yamamoto are designated as Senior managing Officers. Toshihiko Nonaka and Masahiro Yoshida are the managing Officers while Yuji Shiga, Kohei Takeuchi, Shinji Aoyama and Noriya Kaihara are

Sexual Revolution and Methods of Contraception Essay

Sexual Revolution and Methods of Contraception Birth Control and Contraceptives The sexual revolution introduced a whole new idea of controlled births and the use of different forms of birth control. Contraceptives have been used since the time of the ancient Egyptians, but the sexual revolution introduced a whole new form and more efficient way to prevent conception of a child. The use of contraceptives helped control the spread of sexually transmitted diseases, lowered the percentage of illegitimate children, and reduced the risk of pregnancy. Even as early as the times of the ancient Greeks, people could tell the difference between abortifacients and contraceptives. During this era, things such as linen condoms, dried fish†¦show more content†¦A plant called silphium was used effectively as a birth control device until its extinction in the 4th century AD. Another plant that is considered highly effective to the contraception of children is Queen Anne’s Lace. This plant was considered an oral contraceptive dating back 2000 years ago. In the late 1980s, scientists that were experimenting with Queen Anne’s Lace, noticed that the mice they fed the plant to had blocked the production of progesterone and inhibited fetal and ovarian growth. This plant is still used today as a morning-after contraceptive for women in rural areas when they drink the seeds of the plant with a glass of water. Other plants that may be used as birth control include pennyroyal, asafoetida, myrrh, willow, date palm, juniper, pine, and even some foods like onions and cabbage may have some sort of contraceptive powers in them. The problem with using plants as contraceptives is because nature is often random and inconsistent. Different growing conditions and things like different parent plants will all effect the effectiveness of the plants contraceptive powers. (Noble) Intrauterine Device: Intrauterine Devices are one of the oldest forms of birth control known to man. In ancient times, Arabic camel traders would place stones in their camels uterus in order to keep the camel from becoming pregnant in the marketplace. Today, aShow MoreRelatedPower Relations : An Overview Essay1562 Words   |  7 Pageswithin society (ed. Rabinow and Rose 2003). In relation to sex education, we can attribute this subjectivity to macro-level factors such as legislature passed by Congress and religious influence, societal level factors—age and gender and access to contraception, and familial factors—relationship between parents and children. Legislature Several studies have shown an overwhelming amount of support for comprehensive sex education compared to abstinence-only education (Herrman et al. 2013; Bourke 2014).Read MoreThe Arrival Of The Pill979 Words   |  4 Pagestime there existed a method of contraception that separated birth control from the act of sexual intercourse, while having a nearly one hundred percent success rate. When the pill hit the market, at the peak of the baby boom, it was overwhelming mothers who rushed to get it. While some commentators feared that the pill would wreak havoc on morals and sexual behaviour (some even going as far to say that it would lead to adultery), others claimed that it would cure the social, sexual and political illsRead MoreBirth Control And The Pregnancy Prevention1284 Words   |  6 Pagesthat women should maintain the right to protect themselves against unwanted pregnancies. Margaret Sanger is The Woman Rebel who, despite overwhelming opposition, pioneered the way for moder n family planning and, more importantly, the female sexual revolution. The subject of birth control and the debate on whether birth control should be used is not a new subject. For centuries, women were using primitive and unsafe means of birth control to prevent pregnancies. Women had little education on theRead MoreOral Contraceptive Pill And Its Effects On The Way Different People Experience Sexuality Essay1818 Words   |  8 Pagesin terms of contraception have impacted on the way different people experience sexuality throughout history, but the extent to which they shape these experiences is a highly contested topic. The introduction of the oral contraceptive pill in the early 1960s is often attributed as the spark of the ‘sexual revolution’ as it put the power of a woman’s fertility in her hands, but I will argue that the feminist movement of the 1970s (as a social factor) had more of an effect on the sexual freedom of womenRead MoreWhy Do We Continue to Debate the Use of Contraception Essay1572 Words   |  7 PagesContrac eption is it right or wrong and are you to young to decide for yourself? Recently we have been hearing a lot about Contraception ad if it is right or wrong and who gets to decide. 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Birth control was not merely a technique to expand the realm of personal freedom; it grew out of a radical political ideology that contributed to the liberation of women, especially working-class women. Although the idea of contraception marginalized those who believed that birth control was against the laws of God and nature, Margaret Sanger’s campaign sought rights for women to control their own physical destinies. This paper analyzes three documents— including excerpts fromRead MoreThe Birth Control Of Women1501 Words   |  7 Pagesdoors to spaces where women weren’t allowed prior. A person controlling their own fertility is an essential component of creating economic security, limiting unwanted pregnancies, and creating healthier families. There are many new options for contraception for women today, but the pill was the original catalyst in the United States for women claiming control over their fertility, career, and overall health status. The concept of family planning can be traced back to a nurse, sex educator, and politicalRead MoreEugenics and Planned Parenthood Essay1405 Words   |  6 Pages When one contemplates the concept of eugenics, few think of modern contraception and abortion when in reality they are one in the same. The American Eugenics Society, founded in 1923, proudly proclaimed that men with incurable â€Å"conditions† should be sterilized. However these conditions were often none that could be helped, such as, one’s intelligence, race, and social class (Schweikart and Allen 529-532). The purpose of the society was to create the perfect class of men; elite in allRead MoreSex Education Is The Teaching Of Issues1048 Words   |  5 Pagescorrect option of sexual expression for teenagers. Abstinence Only Until marriage that â€Å"teaches abstinence as the only morally correct option of sexual expression for unmarried young people. Abstinence Plus Programs which teach infor mation about contraception and condoms in the context of strong abstinence messages.Comprehensive sexuality education teaches about abstinence as the best method for avoiding STDs and unintended pregnancy, but also teaches about condoms and contraception to reduce the

Clinical Case Conference Report

Question: Discuss about the Clinical Case Conference Report. Answer: Introduction This is a clinical case conference report of a patient who is 51 years of age who has been admitted to the hospital with the chief complaints of severe headache, blurred vision and vomiting and a diagnosis of Astrocytoma. Prior to admission, the patient had a very supportive family as he lived with his wife and two children and his relatives visited him often. At the time of admission, he needed a little bit of assistance with his daily life activities but presently, he is no more independent. He needs nursing care with sling lifter, suffering from a stage 4 sacral ulcer and has got VRE. Apart from this, he has the past medical history of lung fungal infection, high cholesterol, UTI, high blood pressure, chronic back pain, B-cell lymphoma and diabetes type 2. This report will explore the medical condition of the patient and consider the assessment of his pathophysiology, nursing interventions, medications, problem evaluation and nurse to patient-specific education. Case Management Presently, the patient has been diagnosed with the pathophysiological condition of astrocytoma along with severe headache, blurred vision and vomiting. Astrocytoma is a type of brain cancer that originates in the cerebrum in star-shaped brain cells called astrocytes. This tumor does not tend to spread out of the spinal cord and brain and does not affect other organs. It is the commonly occurring form of glial tumor and can appear on several parts of the nervous system and the brain that includes cerebrum, cerebellum and other central parts of the brain, spinal cord and the brainstem. The exact pathogenesis of the tumor is unknown like many other types of tumors (Wick et al. 2012). As symptoms of the diagnosis, severe headache with vomiting and blurred vision occurred. Along with this, he needs the management of some of his chronic problems like subdural hemorrhage, VRE, high cholesterol, high blood pressure, diabetes and chronic back pain. Since the patient is suffering from astrocyt oma, it aggravated his other chronic problems. Clinical assessment using a system based approach like ISBAR can be used to explain the relationship of nursing management with medical management. Since the patient is suffering from astrocytoma, he is having severe headache as a symptom for which analgesic medication like paracetamol has been prescribed. Apart from this, nursing intervention like setting the administration of narcotics can be done with the rationale of providing sedative effect and elimination of anxiety and discomfort. The involvement of interdisciplinary teams of healthcare professionals like social worker, psychologist, palliative team, nurses and dietician is essential as each team member contributes their unique expertise. It is also required to overlap their professional skills and practice areas for providing seamless care coordination in a complex situation of astrocytoma to minimize morbidity, optimize survival and maximize the quality of life. Primary healthcare strategies for astrocytoma include operativ e intervention by the application of radiation therapy and chemotherapy (Jones et al. 2013). The primary strategies are decided by the team of professionals involved in the care process and include input from the concerned neurologist and oncologists. For the nursing management of his chronic back pain, the lumbar flexion can be improved by changing the sleeping position and encouraging him for bed rest. Assessment of his standing and moving posture by the nurse can also help in the management of his chronic back pain. For the nursing management of his diabetes type 2, encouragement of physical activity and enteral nutrition support are provided for improving his functionality and dependence and for providing diet that is low in carbohydrate and high in monounsaturated fat for improving his quality of life. Medical management and treatments described for the patient include pharmacological and non-pharmacological treatments with pain management for his pathophysiological condition. Considering his present diagnostic condition of astrocytoma and other problems like subdural hemorrhage, diabetes, chronic back pain, UTI and other problems, he has been prescribed medications like Enoxaparin, Dexamethasone, Enoxaparin, Novorapid, Paracetamol, Fentanyl, Vancomycin and other medications respectively for management of the problem and the side effects emerging out of the medications. This is evident from the prescribing of the medications Movicol and Coloxyl Senna as they are the laxatives and has been prescribed for the management of constipation occurring out of the medication side effects like antibiotics. This is the pharmacological management provided for pain and discomfort. For the non-pharmacological management of astrocytoma, mechanical thromboprophylaxis is an effective tool to reduce bleeding as the patient is also suffering from subdural hemorrhage. Foot pump devices, intermittent pneumatic compression and graded elastic stockings are other non-pharmacological measures for the management of astrocytoma (Fontebasso et al. 2014). For cancer-related pain, muscle relaxation, diaphragmatic breathing and guided imagery are the preferred non-pharmacological treatment and for the management of his chronic back pain, behavioral therapy can be effective for short-term pain management and as an adjunctive therapy, hypnosis can be used. For his diabetes 2, stress management, physical activity and diet are the preferred non-pharmacological treatment (J?wiak, Nabbout and Curatolo 2013). The relevant diagnostic tests for astrocytoma include physical examination and along with that several other methods can be employed like biopsy, magnetic resonance imaging (MRI) and computed tomography (CT) scan. Biopsy can definite the diagnoses of tumor while the other two types can suggest the presence of a tumor. The diagnosis of chronic back pain will include physical exam that will be followed by CT scan, X-rays and MRI. MRI can be the most effective way to determine the damage of the pinched nerve and disk compared to X-rays and CT scan (Center et al. 2012). For his diabetes type 2, glycated hemoglobin (A1C) test, oral glucose tolerance test, fasting blood sugar test and random blood sugar test will be included (Inzucchi et al. 2012). Screening tests can be included for the patient that will include initial glucose challenge test and follow-up glucose tolerance test. Apart from these diagnostic tests, other tests will be carried out for determining his other medical complicat ions that include rectal swabs or urine and stool samples for VRE, lipid profile tests for high cholesterol and a pressure measuring gauge for measuring the blood pressure. Psychosocial, environmental and economic aspects can be discussed concerning the patient condition since he is suffering from a number of complications apart from astrocytoma. With such a burden of diseases, the patient will undergo a number of medical procedures during his stay in hospital. Therefore, psychosocial support has to be provided to the patient to avoid the stress of the treatment and diagnostic procedures and make him realize the meaning of the results of the tests. This will lessen the psychological pressure on the aged patient and aid him with emotional support (Johnson and Galanis 2014). Environmental aspects can be the root cause of the burden of disease for the patient and therefore, it is advised that a healthy environment has to be provided to the patient for his quick recovery. The key areas of risk have to be identified and eliminated since the patient is suffering from VRE, he should be provided with a protective environment to control the further growth of the disease. Since the treatment of such a large number of diseases can be another economical burden on the patient and his family, it can be reduced by avoiding the developing of the diseases like sacral ulcer by effective nursing management by constant changing of his sleeping posture and maintaining a moist environment (Strowd et al. 2016). Ethical aspects included, in this case, will be to make the treatment cost-effective and maximize the health benefits with the provision of limited resources. The patient should be discussed with his prognosis and diagnosis, his quality of life should be monitored during and after the procedure of treatment and there should be respect for non-maleficence, beneficence, justice and autonomy (Frederickson and Ghere 2013). The legal aspects can be stated as according to the common and statute law of Australia, the confidentiality and privacy of the medical information of a patient should be well maintained. This is particularly important in this case as the patient is suffering from many diseases and a multidisciplinary team of professionals is involved in the care management of the patient. The Health Services Act 1988 states that disclosing of the patient information is strictly prohibited that leads to his identification unless he has committed an offense under the law (Legislation.vi c.gov.au 2016). Education needs of the patient and the family will include a detailed description of his complications by the nurse including astrocytoma along with any relevant grouping or classification, associated symptoms, diagnostic tests and the treatment guidelines. The family will be provided with the education materials and education regarding care providing at home after discharge. Nurse to patient-specific education will also include the guidance on his activities of daily living where he needs assistance as he has lost his independence post his admission to the hospital (Bastable 2016). Discharge planning will include considering him to get admitted in a nursing home or hospice as the patient is in need of active treatment like transfusion. Since he requires the support of three persons with his sling lifter, it would not be safe for him to return to his home. Therefore, the factors like available assistance, architectural barriers, quality of life and availability of home therapy has to be considered while planning his discharge. As the patient is not safe physically or cognitively and there is no assistance available at his home, facility with assisted living has to be planned on discharge (Altfeld et al. 2013). Hospice can be preferable for the patient as his prognosis is poor and it can provide him with tremendous support for the patient and his family for improving his quality of life. Evidence for Current Practice The patient presented with the diagnosis of astrocytoma along with several other complications like subdural hemorrhage, chronic back pain, diabetes type 2, high blood pressure, high cholesterol and VRE. Apart from this, he was having sacral ulcer stage 4 and complaints of severe headache and vomiting with blurred vision. For these complaints, he has been provided with the necessary pharmacological and non-pharmacological interventions and discharge plans have been prepared. However, there are several research findings that are relevant to the case management. Few of the critical complications like astrocytoma, chronic back pain and diabetes type 2 will be selected and associated with the research findings for critiquing the provided management and suggesting alternative management. Ouyang et al. (2014) carried out a research work that discussed the present and future of the management of astrocytoma. The research work is relevant to the case management of the patient as it focused on medication and surgery and for the patient, medications were prescribed for management of the disease. The article also expressed the various parameters of the disease that were in alignment with the clinical condition of the patient and its subsequent management. Kahn, Cooper Del Prato (2014) carried out a similar study to explore the treatment and pathophysiology of diabetes type 2 and this has resemblance with the present case of the patient as it discussed the treatment procedure which was similar to that of the patient. Novorapid is the insulin analog that has been prescribed to the patient and the article also discussed about the potential benefits for the using insulin as the frontline treatment of diabetes type 2. Gatchel et al. (2014) carried out a similar research work f or discussing the aspects of chronic pain management and it had relevance to the case of the patient as it suggested interdisciplinary therapy for pain management and the patient was also provided with a multidisciplinary team for managing his pain and discomfort due to the burden of a number of diseases. The management and care provided to the patient can be compared and critiqued with the research finding and best practice that has been included in the literature. For astrocytoma, the research finding by Ouyang et al. (2014) stated that surgical management is the standard treatment procedure for the disease whereas, the patient has been prescribed with medications like Enoxaparin, Filgrastim and Dexamethasone. Pharmacological management of astrocytoma has been proposed by mTOR inhibitors like everolimus and sirolimus in the research finding for maximum therapeutic benefits but the patient has not been prescribed these medications for his management of the disease. Since the mTOR inhibitors have been proved to be potentially beneficial for the treatment of astrocytoma, prescribing them could have been considerably reduced the burden of the diseases that the patient is suffering from. So, it can be stated that there have been deviations in the management of astrocytoma of the patient when compared to the best practice provided in the literature. A similar finding has been derived from the research literature by Kahn, Cooper Del Prato (2014) for the management of diabetes 2 of the patient where the researchers have found that the second generation sulfonylurea antidiabetics like Gliclazide, Glibenclamide and Glipizide can be equally effective as insulin. Although the researchers have proposed insulin as the first line of therapy for diabetes 2, it has several side effects like hypoglycemia, neuropsychological impairment, ocular disturbance and lipohypertrophy. These can be avoided with the use of the proposed medications of the researchers that can act to reduce the disease burden effectively, without adding up the side effects of insulin with the administration of Novorapid. Keeping in tune with the research findings, Gatchel et al. (2014) has described chronic pain as a costly and significant problem and considering the economic aspects of the patient, it can be stated that he is a huge burden of expenditure due to the treatment of the large number of diseases that he is suffering from. For providing cost effective treatment of his chronic back pain, the authors have proposed interdisciplinary programs of pain management considering the social, psychological and physiological factors including family, cognitions and medications. However, in the present case, although there has been an involvement of the multidisciplinary team for his treatment and medications has been provided, incorporation of the psychological parameters like attention, behavior, emotions and cognitions can improve his pain without adding up to the extra cost. The nurse will be required to play an integral role in the process by monitoring and evaluating the treatment outcomes and maintaining effective communication with the treatment team. There have been these deviations when the best practice was compared and critiqued with the nursing care and management of the pat ient. Apart from the treatment procedures adopted in the research literature, several other options can be suggested for the alternative management or nursing care of the patient. Corticosteroid therapy can be effective in the management of astrocytoma and medical therapies can be complimented with the application of biobehavioral nursing interventions (Seyfried et al. 2012). Alternative approaches of taking Chromium, Alpha-Lipoic Acid, Aloe Vera and Cinnamon can significantly control the diabetes type 2 of the patient and the nurse educators are expected to provide appropriate guidance to the patient regarding these alternative therapies (Ley et al. 2014). Chiropractic manipulation can be an effective alternative for the management of chronic back pain and the nurses providing physical and psycho-social support to the patient can add up to the procedure (Chaparro et al. 2014). Conclusion From the case, it is evident that the patient is under a huge burden of several diseases that requires effective management and nursing care. An effective clinical case conference report will aid to understand the case of the patient better and find out the gap in the present treatment regime. Filling up of the gap by the management strategy from the research findings can help to support the multidisciplinary team with the easy management of the diseases and provide psychosocial and economic support to the patient. The ethical and legal aspects have to be considered to provide effective treatment and support to the patient and his family within the permitted regulations by the Australian authority of healthcare. This report identified several crucial aspects that can effectively modify the treatment procedure and efficiency of the patient. References Altfeld, S.J., Shier, G.E., Rooney, M., Johnson, T.J., Golden, R.L., Karavolos, K., Avery, E., Nandi, V. and Perry, A.J., 2013. Effects of an enhanced discharge planning intervention for hospitalized older adults: a randomized trial.The Gerontologist,53(3), pp.430-440. Bastable, S.B., 2016.Essentials of patient education. Jones Bartlett Publishers. Center, C., Relief, P., Covington, L.A. and Parr, A.T., 2012. Caudal epidural injections in the management of chronic low back pain: a systematic appraisal of the literature.Pain Physician,15, pp.E159-E198. Chaparro, L.E., Furlan, A.D., Deshpande, A., Mailis-Gagnon, A., Atlas, S. and Turk, D.C., 2014. Opioids compared with placebo or other treatments for chronic low back pain: an update of the Cochrane Review.Spine,39(7), pp.556-563. Fontebasso, A.M., Papillon-Cavanagh, S., Schwartzentruber, J., Nikbakht, H., Gerges, N., Fiset, P.O., Bechet, D., Faury, D., De Jay, N., Ramkissoon, L.A. and Corcoran, A., 2014. Recurrent somatic mutations in ACVR1 in pediatric midline high-grade astrocytoma.Nature genetics,46(5), pp.462-466. Frederickson, H.G. and Ghere, R.K., 2013.Ethics in public management. ME Sharpe. Gatchel, R.J., McGeary, D.D., McGeary, C.A. Lippe, B. 2014, "Interdisciplinary chronic pain management: past, present, and future",The American psychologist,vol. 69, no. 2, pp. 119-130. Inzucchi, S.E., Bergenstal, R.M., Buse, J.B., Diamant, M., Ferrannini, E., Nauck, M., Peters, A.L., Tsapas, A., Wender, R. and Matthews, D.R., 2012. Management of hyperglycemia in type 2 diabetes: a patient-centered approach position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD).Diabetes care,35(6), pp.1364-1379. Johnson, D.R. and Galanis, E., 2014, August. Medical management of high-grade astrocytoma: current and emerging therapies. InSeminars in oncology(Vol. 41, No. 4, pp. 511-522). WB Saunders. Jones, D.T., Hutter, B., Jger, N., Korshunov, A., Kool, M., Warnatz, H.J., Zichner, T., Lambert, S.R., Ryzhova, M., Quang, D.A.K. and Fontebasso, A.M., 2013. Recurrent somatic alterations of FGFR1 and NTRK2 in pilocytic astrocytoma.Nature genetics,45(8), pp.927-932. J?wiak, S., Nabbout, R. and Curatolo, P., 2013. Management of subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis complex (TSC): clinical recommendations.european journal of paediatric neurology,17(4), pp.348-352. Kahn, S.E., Cooper, M.E. Del Prato, S. 2014, "Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future",Lancet (London, England),vol. 383, no. 9922, pp. 1068-1083. Ley, S.H., Hamdy, O., Mohan, V. and Hu, F.B., 2014. Prevention and management of type 2 diabetes: dietary components and nutritional strategies.The Lancet,383(9933), pp.1999-2007. Ouyang, T., Zhang, N., Benjamin, T., Wang, L., Jiao, J., Zhao, Y. Chen, J. 2014, "Subependymal giant cell astrocytoma: current concepts, management, and future directions",Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery,vol. 30, no. 4, pp. 561. Seyfried, T.N., Marsh, J., Shelton, L.M., Huysentruyt, L.C. and Mukherjee, P., 2012. Is the restricted ketogenic diet a viable alternative to the standard of care for managing malignant brain cancer?.Epilepsy research,100(3), pp.310-326. Strowd, R.E., Abuali, I., Ye, X., Lu, Y. and Grossman, S.A., 2016. The role of temozolomide in the management of patients with newly diagnosed anaplastic astrocytoma: a comparison of survival in the era prior to and following the availability of temozolomide.Journal of neuro-oncology,127(1), pp.165-171. Victorian Legislation and Parliamentary Documents. (2016).Legislation.vic.gov.au. Retrieved 8 November 2016, from https://www.legislation.vic.gov.au/ Wick, W., Platten, M., Meisner, C., Felsberg, J., Tabatabai, G., Simon, M., Nikkhah, G., Papsdorf, K., Steinbach, J.P., Sabel, M. and Combs, S.E., 2012. Temozolomide chemotherapy alone versus radiotherapy alone for malignant astrocytoma in the elderly: the NOA-08 randomised, phase 3 trial.The lancet oncology,13(7), pp.707-715.