...NATIONAL HEALTH INSURANCE SCHEME TIONAL H NA E H INSUR LT A A OPERATIONAL GUIDELINES REVISED OCTOBER, 2012 National Health Insurance Scheme P.O.W. Mafemi Crescent Off Solomon Lar Way, Utako P. M. B 400, Garki Abuja, Nigeria Tel: 234-1-4130026-7 Fax: 234-1-4130028 Email: info@nhis.gov.ng Website: www.nhis.gov.ng All rights reserved. No part of this publication may be reproduced, transmitted, transcribed, stored in a retrieval system or translated into any language or computer language, in any form or by any means electronic, mechanical, magnetic, chemical, thermal, manual or otherwise, without the prior consent in writing of the National Health Insurance Scheme. 1 CH E S EME NC © National Health Insurance Scheme ISBN 978 2397 24 5 REVISED October 2012 2 TABLE OF CONTENTS Foreword Acknowledgement Introduction Definition of Key Terms SECTION ONE (PROGRAMMES) * Introduction * Formal Sector Social Health Insurance Programme * Definition * Roles and responsibilities of Healthcare Facility under the Formal Sector Social Health Insurance Programme * Roles and responsibilities of HMO under the Formal Sector Social Health Insurance Programme * Roles and responsibilities of NHIS under the Formal Sector Social Health Insurance Programme * Organization of Health Services * Guidelines For Public Sector And Organized Private Sector * Membership * Contributions * Waiting Period * Scope of Coverage * Registration of Employers and Employees * Rights and Privileges of...
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...Week 6- Reading Objectives • Chapter 42- Diseases of Bones and Joints o After reading this chapter, the reader should be able to: Evaluate osteomyelitis from the standpoint of: • Types and Etiology • Clinical Evaluation and Laboratory Studies • Imaging Studies • Treatment Evaluate arthritis from the standpoint of: • Inflammatory Arthritis o Etiology and Classification o Evaluation and Treatment • Noninflammatory Arthritis o Etiology and Classification o Evaluation and Treatment • Infectious Arthritis o Etiology o Clinical Presentation o Laboratory and Imaging Studies o Treatment and Complications Evaluate arthritic and other disorders of: • The hip o Examination and Imaging o Treatment Nonsurgical Surgical • The Knee o Examination and Imaging o Treatment Nonsurgical Surgical • Foot and Toes (pay particular attention to Diabetic foot problems) o Examination and Imaging o Treatment Surgical Nonsurgical Chapter 45- Fractures o After reading this chapter, the reader should be able to: Classify fractures according to pattern/mechanism Evaluate an extremity using the MEISS (mangled extremity severity score) variables (Table 45-2) Evaluate and Classify Open Fractures (Table 45-1) 1 • Omit (Injuries to the Spine) pp. 541-548 Evaluate Clavicle Fractures • Etiology and Classification • Examination Findings and Imaging • Treatment (Surgical and Surgical) Evaluate Upper Extremity Fracture including • Proximal Humus Fractures • Humeral Shaft Fractures • Fractures about the Elbow o...
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...LOWER RESP DRUGS 1.The nurse is caring for a patient with a theophylline level of 14 mcg/mL. What is the priority nursing intervention? Continue to assess the patient’s oxygenation. The therapeutic theopylline level is 10 to 20 mcg/mL. The nurse should continue interventions and monitor oxygenation. 2. In discharge teaching, the nurse will emphasize to a patient receiving a beta-agonist bronchodilator the importance of reporting which side effect? Tachycardia A beta-agonist bronchodilator stimulates the beta receptors of the sympathetic nervous system, resulting in tachycardia, bronchodilation, hyperglycemia (if severe), and alertness. 3. What over-the-counter product will the nurse instruct the patient to avoid when taking montelukast (Singulair)? St. John’s wort St. John’s wort has been shown to decrease serum montelukast (Singulair) levels. The other substances do not interact with montelukast. 4. The patient is taking a nonselective adrenergic agonist bronchodilator and has a history of coronary artery disease. What is a priority nursing intervention? Monitoring patient for potential chest pain Nonselective adrenergic agonist bronchodilators stimulate beta1 receptors in the heart and beta2 receptors in the lungs. Stimulation of beta1 receptors can increase heart rate and contractility, increasing oxygen demand. This increased oxygen demand may lead to angina or myocardial ischemia in patient...
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...General Characterists of Antimicrobials- 1.Antibacterial – broad spectrum, narrow spectrum- gram positive, gram negative Broad spectrum to start the process of healing until c&s results – then treat with narrow spectrum susceptible to antibiotic Obtain C&S before administering antibiotics Gram positive stains pinkish Gram negative stains purple-ish blue Bactercidal – kills Bacteriostatic – inhibits growth Side Effects – allergy in 1st 30min – nausea, vomiting, dirreaha Teaching – fluids, yogurt, probiotics, take as directed 2.Antiviral Interrupt cell metabolism 3.Antifungal Mechanisms of action – Inhibits cell wall synthesis Inhibits protein synthesis Inhibits organism reproduction via DNA Inhibits cell metabolism and growth Indications for use- Infection or prophylactic Resistant to one drug in class / resistant to all in class – become resisitant when antibiotic is taken to often or dose not finished (Directly Observed Therapy to prevent) Culture and sensitivity to determine suseptablity, intermedicate or resistant Difference between virus and bacteria – no cell wall in virus Antibacterials work on cell wall of bacteria Virus – wash hands Lower doses for kidney/liver failure to avoid toxicity – dependent on creatine clearance >60 normal Renal failure inhibits excretion and causes build up of antibiotic Vitamin B6 for tingling fingers Septic = low blood pressure *prototype *class *action at cellular level ...
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...10/31/12 Absolute vs. Relative In the biblical reading of Exodus 20:1-17, Matthew 22:34-40 it basically talked about the Ten Commandment, saying that it is absolute. There is not too much really debate about, stating that you shall not murder, shall not steal and so on. It is more of the ideal way of how we should live by and it could be hard to do so because we don’t live in a perfect world. Also following the commandments could be hard to do if you are not religious. But then again not to many people would disagree with the Ten Commandments. Talking about relative we read an article on the topic. In the Ten Commandments its states that I shall not commit adultery, but if we decide to do so we can. Is it wrong to cheat on your husband or wife, yes but there is even a website that basically lets you meet people who want to commit adultery. There is even someone who is making money off of this idea. So I personally think that it is not okay but we do have the freedom to do so and that really goes back to what we think is right. When it comes to the question of which ethical system leads to a more virtuous life, I’m more of for relative. I think I have the tools to know what is right and wrong; it is up to me to make choses. Now I am not saying go around and do bad things because I know I will be forgiven, but I do think that I have to make some mistakes to really learn what I truly believe in. I think the absolute there is no real way to argue against it and what is...
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...1. Identify several factors that can influence individual differences in medication response. 2. A client is prescribed phenobarbital sodium (Luminal) for a seizure disorder. Phenobarbital has a long half-life of 4 days. Based on the half-life of phenobarbital, it will most likely be prescribed a. Once a day b. Twice a day c. Three times a day d. Four times a day 3. An order has been written to “draw peak and trough levels” for a particular medication. When should blood be drawn for each level? 4. A medication has to bind to a ________ in a cell to produce and effect. 5. Medication dosages may need to be decreased for which of the following reasons? (Select all that apply) ____ Increased renal excretion ____ Increased medication-metabolizing enzymes ____ Liver failure ____ Peripheral vascular disease ____ Concurrent use of medication metabolized by the same pathway 6. Proper administration of eye drops should include which of the following nursing interventions? (Select all that apply) ____ Using medical aseptic technique ____ Asking the client to look up at the ceiling ____ Having the client lie in a side-lying position ____ Dropping medication into the center of the client’s conjunctival sac ____ Instructing the client to close the eye gently 7. A nurse is preparing a client’s medications. Which of the following are legal responsibilities of the nurse? (Select all that apply) ____ Maintaining skill competency ____ Determining...
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...Part 1- Framing the Project Portfolio Management Problem 1. What are the objectives? The objective is to research and develop pharmaceuticals products based on the selections that minimize cost and maximize value and sales. There will be a discussion of which projects will be allocated additional resources and at what cost. 2. What are the constraints? Competition is usually between brand-name drugs. Constraints for the study include risky drug discovery and development which could cause harm to participants and also waste money used on development. Other restrictions include the amount of time spent on Research and Development which leads to increased costs. There is also the concern with low return on investments and the emergence of generic drugs and competitors. 3. What are the risks involved? There are both technical and commercial risks involved. The most risky aspect of the project is within the research and development process. Drug discovery and development is extremely risky, time-consuming, and expensive. Millions of dollars are spent in the R& D process and many of the drugs created do not make it past the Basic Research stage. The risks associated with low return on investment or no return at all on the investment pose a big risk for pharmaceutical companies. 4. What are your alternatives? The company can choose to allocate resources to other projects or services besides pharmaceutical drugs. There are possible lines extensions in the areas of cardiovascular...
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...Turing Pharmaceuticals RES/351 Turing Pharmaceuticals In recent weeks Turing Pharmaceuticals has been in the news for raising the price of prescription drugs. The price of Daraprim, a drug to treat toxoplasmosis, was increased by over five thousand percent. The increase has sparked people from both the AIDS and cancer organizations to reach out and attack the ethics of Chief Executive Officer, Martin Shkreli through social media. The increase in price may prevent hospitals from having treatment available for patients who need it. The practice of price gouging prescription drugs has now become an important political topic many candidates running for President of the United States in 2016 will be talking about. Significance of a Solution Recognizing that developing, manufacturing, and marketing pharmaceuticals is a very profitable business, the case of Turing Pharmaceutical’s purchase and marketing of the drug Daraprim spotlights a potentially serious issue with the way some companies “repackage” existing drugs to create higher profit margins. Daraprim (Pyrimethamine) was originally approved January 23, 1953 for the treatment of toxoplasmosis, an infection caused by a very common parasite (U.S. Food and Drug Administration, n.d.). Because most people never exhibit symptoms of this disease, sales of this drug were very small; and, no generic drug company ever bothered to duplicate the formula (Mayo Clinic, 2015). Seizing the opportunity to “corner the market” on this...
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...Amanda McCloskey Clinical Trials in Children Pharmacology NURS 2820 Anoka Ramsey Community College Children are a unique population with distinct differences from adults. As they grow and develop, several changes occur and therefore it is difficult to predict a child’s response to a drug. This was one of the main reasons children were not included in drug trials until recently. Absence of regulation that required drug companies to conduct trials in children, and lack of facilities, equipment/technology, and expertise were also challenges that discouraged drug testing in children. In addition, there were numerous ethical concerns which involved fears of harming children and increased liability issues (The Necessity and Challenges of Clinical Research Involving Children, 2004). As a result, children did not receive potentially lifesaving or beneficial treatment when needed. Clinical trials in children are critical because they provide information on the drug’s safety, dosing, and effectiveness (Drug Research and Children, 2011). Prior to the 1990s, the FDA did not acquire legislation related to investigating drugs in children. The Pediatric Rule of 11994, mandated drug labels to consist of instructions for children, however it proved to be fairly ineffective since the information used on these labels was based on adult dosing and trial and error in pediatric patients. In 1997 the Food and Drug Administration Modernization Act (FDAMA) was established. The act did...
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...Pathopharmacological Foundations for Advanced Nursing Practice Competency Assessment WUT Task 1 Pamela L. Taylor RN-C(OB), BSN Western Governors University June 2016 A. Disease Process For the purpose of discussion of pathopharmacological features of a specific disease process, this paper will provide information related to heart disease in the form of coronary artery disease (CAD). A1. Pathophysiology Analysis Cardiovascular disease (CVD) is the number one cause of mortality worldwide and becoming a steadily more investigated problem due to its prevalence. Much research is going into genetic, inflammatory mechanisms and neuro-hormonal factors related to CVD as scientific knowledge evolves regarding complexity of this broad pathophysiology. Atherosclerosis is the leading cause of the subsection of CVD called CAD. This is a form of arteriosclerosis where there is progressive thickening and hardening of the vessel walls of the two major coronary arteries and their branches. The thickening is an accumulation of lipid-laden macrophages inside the wall of the artery leading to the formation of lesions and plaque buildup (McCance, K. & Huether, S., 2014). When the plaque develops on the coronary artery walls the pumping ability of the heart becomes impaired as oxygen and nutrients needed for heart function may be partially or completely impeded. Complete occlusion of a coronary artery or one of its branches leads to a myocardial...
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...Salix has been a successful pharmaceutical company for 15 years. They have used the “search and develop strategy” in the US GI market for continued growth. The question remains can they continue to be successful with this narrow strategy or do they need to alter their mission? Do they need to revamp their “search and develop” strategy? Key issues Salix encounters are increased use of generics, limited scope of disease treatment, and dependency upon other research companies to initially start and develop chemicals. If Salix wants to expand their strategy scope, they could focus on medications in other areas of the body, they could expand outside of the US market, they could further develop their international partner network, or they could focus on their own research instead acquiring licenses and rights to other chemicals. Introduction Salix is a small pharmaceuticals company started in 1989. Since this time, Salix has acquired the rights to develop and market four major prescription compounds. They have become a successful player in the US gastrointestinal market, while profiting from licensing their products in other countries. Although Salix has been successful, the co owners must make a decision on whether or not their current strategy is sustainable. Can they still “search and develop” acquired compounds and stay successful? Salix needs to determine if their existing prescription drugs’ profitability can last while they find another research companies drugs...
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...CHEM 5 Quantitative Analysis Laboratory Outline. 55labout.doc 02/06/05 Objectives: • development of quantitative laboratory skills • introduction to modern analytical science • Approach: • solve a series of chemical analysis problems with various techniques and instruments • certify laboratory instruments and standards • maintain laboratory records in compliance with Good Laboratory Practice Guidelines Schedule: Weeks 1-6 - Perform a Basic Set of 8 fundamental experiments (Series A) Weeks 5-15 Two parallel activities will be sustained: - Perform a series of quantitative studies (Series B) - Calibration of laboratory instruments (Each student or student group will perform each experiment in the B-series.) (Each student or student group will perform the calibration of laboratory instruments __________________________________________________________________ Series A. Basic Quantitative Techniques Introductory Experiments (A-1) Experiment 1 Use of the Analytical Balance (page 727) (A-2) Experiment 2 Use of the Pipet and Buret and Statistical Analysis (page 729) Gravimetric Analysis (A-3) Experiment 3 Gravimetric Determination of Chloride (page 730) Volumetric Analysis Acid-Base Titrations Neutralization Titrations (A-4) Experiment 6 Determination of Replaceable Hydrogen in Acid by Titration with Sodium Hydroxide (page 736) (A-5) Experiment...
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...Legal and Ethical Considerations in Marketing, Product Safety, and Intellectual Property LEG 500 August 26, 2014 Legal and Ethical Considerations in Marketing, Product Safety, and Intellectual Property Ethical dilemma may be defined as a situation where one has to make a decision but the decision to be made has some impact on either of the choices taken. In different organizations, there are times where a manager may be faced by ethical dilemmas that he or she is supposed to look into. The process may be difficult since the manager has to deal with such situations without discriminating on any individual. Any activity that relate to business management in relation to the society, consumers, and the business itself should consider all ethical issues relating to the environment. It is important for business owners to alight ethical issues to their business plans. Ethical issues may relate to advertising and marketing, regulation of product safety, and intellectual property. Marketing and advertising, relating to any industry in the market, may have different forms of ethical issues. For example, advertising may be unethical when the content in the advertisement has unethical issues such as the use of harsh language or pictures that may not be pleasant to all age groups (Ashcroft, 2007). It is important for advertising agencies to consider all ethical factors while posting any advertisement to the public. In addition, marketing may lead to unethical issues...
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...Olayemi et al., Journ. Pharm. Sci., March, 2008, Vol. 7 No. 1, P. 131– 138 Nigerian Journal of Pharmaceutical Sciences Vol. 7, No. 1, March, 2008, ISSN: 0189-823X All Rights Reserved COMPARATIVE EVALUATION OF MAIZE, RICE AND WHEAT STARCH POWDERS AS PHARMACEUTICAL EXCIPIENTS *Olayemi O. J., Oyi A. R. and Allagh T . S. Department of Pharmaceutics and Pharmaceutical Microbiology, Ahmadu Bello University, Zaria *Author for Correspondence: olubunmibiala@yahoo.co.uk, +234 80 33532299 ABSTRACT This investigation aims at comparing locally developed starches from three grains; Maize (Zea mays), Rice (Oryza sativa) and Wheat (Triticum aestivum) grains. These grains are used mainly as foods and they contain high amount of carbohydrate. The presence of starch in these grains varies and thus their use as pharmaceutical excipients will vary to the degree of their starch functionality. The powders obtained were characterised for their particle size, particle size distribution. The organoleptic and physicochemical characterisation such as viscosity, hydration capacity, swelling capacity, moisture sorption capacity, pH, flow rate and porosity, Carr’s index and Hausner’s ratio were evaluated. The powders passed the identification and solubility tests as required by the BP. Rice starch showed the least Carr’s index, Hausner’s ratio, porosity, moisture sorption capacity and the greatest flow rate. Rice starch also showed the highest hydration capacity and swelling...
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...Legal and Ethical Considerations in Marketing, Product Safety, and Intellectual Property Name: Hanadi Rabadi Course: LEG 500 Professor: Gus Weekley Date: 09/01/2014 Legal and Ethical Considerations in Marketing, Product Safety, and Intellectual Propertyt Inreduction Ethical dilemma may be defined as a situation where one has to make a decision but the decision to be made has some impact on either of the choices taken. In different organizations, there are times where a manager may be faced by ethical dilemmas that he or she is supposed to look into. The process may be difficult since the manager has to deal with such situations without discriminating on any individual. Any activity that relate to business management in relation to the society, consumers, and the business itself should consider all ethical issues relating to the environment. It is important for business owners to alight ethical issues to their business plans. Ethical issues may relate to advertising and marketing, regulation of product safety, and intellectual property. Marketing and advertising, relating to any industry in the market, may have different forms of ethical issues. For example, advertising may be unethical when the content in the advertisement has unethical issues such as the use of harsh language or pictures that may not be pleasant to all age groups (Ashcroft, 2007). It is important for advertising agencies to consider all ethical factors while posting any advertisement to the public...
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