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Fibromyalgia (FM) Symptoms, Causes and Treatments

Share this: Facebook Twitter Reddit LinkedIn WhatsApp B. Trimble Fibromyalgia Fibromyalgia (FM) is a condition of unknown etiology, characterized by extensive pain, atypical pain processing, sleep disruption, fatigue, and often psychological distress. People with fibromyalgia may also have added indications, such as morning rigidity, tingling or numbness of the hands and feet, headaches, migraines, irritable bowel syndrome, sleep disorders, cognitive problems, problems with thinking and memory (often called fibro-fog), and additional pain syndromes (CDC, 2010). The American College of Rheumatology (ACR) 2010 criteria is used for clinical diagnosis and severity classification of fibromyalgia (CDC, 2010). The diagnosis is centered on: Widespread pain index (WPI) of greater than or equal to seven and symptom severity scale (SS) of greater than or equal to five, or WPI of three to six and SS of greater than nine (CDC, 2010). Symptoms have been existent at a similar level for at least three months (CDC, 2010) The patient does not have another disorder that would otherwise explain the pain (CDC, 2010). Fibromyalgia often occurs with other rheumatic conditions such as rheumatoid arthritis, up to 25 – 65%, systemic lupus erythematosus, and ankylosing spondylitis (CDC, 2010). The tender point test is replaced with widespread pain index and a system severity scale. The widespread pain index score is determined by counting the number of areas on the body where the patient has had pain in the past week. The checklist includes nineteen areas of the body (Rush University Medical Center, 2010). The symptoms severity score is determined by rating on a scale of zero to three, three being the most prevalent, the severity of three collective symptoms: fatigue, waking tired and cognitive symptoms (Rush University Medical Center, 2010). An additional three points can be added to account for additional symptoms, such as numbness, dizziness, nausea, depression, or irritable bowel syndrome. The final score is between zero and twelve (Rush University Medical Center, 2010). To meet the criteria for a diagnosis of fibromyalgia, a patient would have seven or more pain areas and a symptoms severity score of five or more, or three to six pain areas and a symptoms severity score of nine or more (Rush University Medical Center, 2010). Some criteria remain untouched. The symptoms must have been existent for a minimum of three months, and the patient does not have another disorder that would explain the pain (Rush University Medical Center, 2010). To develop and test the new criteria, researchers implemented a multi-center study of formerly diagnosed fibromyalgia patients and a group of patients with rheumatic non-inflammatory disorders using a physician physical and interview examination (Rush University Medical Center, 2010). The pervasiveness of fibromyalgia affects an estimated five million adults, with more women than men affected (CDC, 2010). Most people with fibromyalgia are diagnosed during middle age, and the incidence increases with age. Although the rates are higher in women, men and children can have the disorder. Women with the disorder that are hospitalized are ten times more likely to return to work, but four times less likely retain work at one year after hospitalization. It is shown that adults with fibromyalgia average around seventeen days of missed work per year compared to six days for those without the disorder (CDC, 2010). The causes and/or risk factors for fibromyalgia are associated with stressful or traumatic events, such as car accidents, post-traumatic stress disorders, repetitive injuries, illnesses (such as viral infections), certain diseases ( such as Rheumatoid arthritis), chronic fatigue syndrome, lupus, genetic predispositions, and obesity (CDC, 2010). People with fibromyalgia respond strongly to things that other people would not find uncomfortable by exhibiting an abnormal pain perception. The ACR recommends a multi-disciplinary treatment plan including screening and treatment for depression, as evidence indicates that depression is a major occurrence with fibromyalgia (CDC, 2010). The recommendation for treatment includes pharmacotherapy, aerobic exercise and muscle strengthening and, education and relaxation therapy (CDC, 2010). Many hormonal, metabolic, and brain chemical deviations have been indicated in studies of fibromyalgia (CDC, 2010).Variations seem to occur in some brain chemicals, although no regular pattern was identified as relevant in most patients with the disorder. Fibromyalgia may be the result of the properties of pain and stress on the central nervous system that leads to alterations in the brain, rather than a brain disorder itself (CDC, 2010). Researchers are concerned with serotonin and the effects on fibromyalgia. Serotonin facilitates feelings of well-being, adjusts pain levels and promotes deep sleep (CDC, 2010). Low levels of serotonin have been noted in patients with fibromyalgia. Research has also found abnormalities in the hypothalamus-pituitary-adrenal gland axis (HPA axis). The HPA axis regulates sleep, stress response, and depression. Changes in the HPA axis may lead to lower levels of stress hormones norepinephrine and cortisol. Lower levels of stress hormones lead to diminished responses to psychological or physical stress (CDC, 2010). According to the ACR, people with fibromyalgia can have irregular levels of substance P in their spinal fluid (FDA.gov). This substance P helps convey and intensify pain signals to and from the brain. Researchers are considering the function of substance P and other neurotransmitters, and studying why people with fibromyalgia have amplified sensitivity to pain and whether there is a gene or genes that cause a person to be more prone to have it (FDA.gov). Many steps have been taken in research in supplying patients with opportunities to understand and address the symptoms of fibromyalgia and quality of life issues. Research continually indicates that a multi-disciplinary approach is the most helpful for the physician and the patient (National Fibromyalgia Research Association). The examination the physician completes when considering a diagnosis of fibromyalgia should include a basic neurologic examination, a referral to a neurologist, and MRI if the exam indicates minimal deficits (National Fibromyalgia Research Association). Exercise is important for fibromyalgia patients. It has an influence on the quality of sleep and helps to keep unaffected muscles strong. Aerobic exercise, strengthening and relaxation assist in decreasing the effects of the disorder (National Fibromyalgia Research Association). There is no one medication that works for all patients (National Fibromyalgia Research Association). Medical professionals and patients must work together to determine which medication or combination of medications are most effective for the individual (National Fibromyalgia Research Association). People with fibromyalgia are normally treated with pain medications, antidepressants, muscle relaxants, anticonvulsants, and sleep aids (FDA.gov). In June 2007, Lyrica (Pregabalin) became the first FDA approved drug for the specific treatment of fibromyalgia; one year later, June 2008, Cymbalta (duloxetine hydrochloride) became the second, and in January 2009, Savella (milnacipran HCL) became the third (FDA.gov). Lyrica, Cymbalta, and Savella reduce pain and improve function in some people with fibromyalgia (FDA.gov). While people with fibromyalgia suffer pain differently from other people, the mechanism by which these drugs yield their result is unknown. There is information proposing that these drugs influence the release of neurotransmitters in the brain (FDA.gov). Lyrica was previously approved to treat seizures, as well as pain associated with damaged nerves in diabetic peripheral neuropathy and those who develop pain from the shingles rash (FDA.gov). Side effects of Lyrica include drowsiness, dizziness, blurred vision, weight gain, swelling of the hands and feet, dry mouth, and difficulty concentrating (FDA.gov). Cymbalta was previously approved to treat depression, anxiety, and diabetic peripheral neuropathy (FDA.gov). Cymbalta side effects include nausea, dry mouth, somnolence, constipation, decreased appetite, and increased sweating. Cymbalta may increase suicidal thinking and the risk of suicidal actions. It may also increase depression in some people (FDA.gov). Savella is the first drug introduced primarily for the treatment of fibromyalgia (FDA.gov). It is not used to treat depression in the United States, but acts like anti- depressants that are used to treat depression and other mental disorders (FDA.gov). Lyrica and Cymbalta are approved for the use in adults eighteen years and older. The drug companies have agreed to study their drugs in children and breastfeeding women (FDA.gov). Other medications used to treat fibromyalgia are pramipexole, tramadol, pindolol, ketamine, sodium oxybate, and gabapentin (National Fibromyalgia Research Association). Many patients achieve pain relief from complementary and alternative medications (CAM). Acupuncture, biofeedback, and massage are popular treatment alternatives. Herbal supplements and medication may also provide chronic pain relief and relieve fatigue (FDA.gov). Much of the research on complementary health approaches for fibromyalgia is still preliminary, and evidence of effectiveness is limited. Some studies have shown that practices such as TaiChi, gi-gong, and massage therapy may help with fibromyalgia symptoms. (Kowlowitz E.J.) Aerobic and strength-training exercises have been associated with important improvements in pain levels, tender point counts, and sleep disturbances. Maintenance of exercise programs indicates that compliance is a problem with patients. Discussion on strategies on improving compliance can be discussed with the patients (Millea
BUS 4044 Capella University Employment Category Analysis Question.

I’m working on a business writing question and need an explanation to help me learn.

Write a 3–4-page analysis in which you examine the different categories of employment. Analyze the pros and cons of each type of worker from an employer’s perspective and then describe the ideal proportion of workers for a business type of your choosing. Provide a supporting rationale for your description. Employment laws are based on the premise of the existence of an employment relationship. Defining whether an employment relationship exists between an employee and employer can be challenging in today’s workplace, because there are so many different forms of employment. Regular, full-time employment used to be the norm. Today, companies hire part-time, temporary, or contract employees; this has impacted the legal rights of the employees performing the work. These alternative work arrangements are often referred to as contingent, or non-standard, work. It is important for HR practitioners and members of management to understand employment relationships and the classification of employees, because this can have a significant impact on the way an employee is paid. This also affects the application of employment laws.By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:Competency 1: Examine the effect of the employment process on current work environments.Discuss the ideal allocation of each employment category.Competency 2: Analyze trends and changes in the laws on diversity, gender, and harassment.Describe each category of worker.Analyze the pros and cons of each type of worker.Describe the ideal proportion of workers based on employment category.Competency 6: Communicate in a manner that is scholarly, professional, and consistent with expectations for members of the human resource profession.Communicate in a manner that is scholarly, professional, and consistent with expectations for members of the human resource profession.Competency MapCHECK YOUR PROGRESSUse this online tool to track your performance and progress through your course.Toggle DrawerContextThis assessment delves into the different types of employment relationships that exist today. Classifying an employee’s status can be almost as important as defining the tasks of the job, especially when courts must interpret the law. In this assessment, you will examine the primary types of work agreements—from handshake and contract, to employment-at-will, and temporary employment.SHOW LESSWhen work needs to be done, hiring the right person is usually foremost on the mind of the employer. How that person is classified once hired, typically, is the responsibility of the HR department. Often that classification may become the single most important factor in resolving workplace disputes. In this assessment, you will explore options for engaging the right people with the best agreement.The most prevalent understanding between an employer and an employee is set at the point of hire, by an agreement to pay a certain wage for a given piece of work under certain terms and conditions. The earliest agreements were based on a symbolic handshake and the bond between the two parties. That symbolic handshake is the basis of employment contracts today, but the symbols and terms have changed considerably.Toggle DrawerQuestions to ConsiderTo deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of the business community.What are the primary benefits and negative aspects of arbitration from the perspective of either an employer or an employee?There is much debate today about the contingency workforce and the former implied permanent relationship in the workforce. Given our global economy and the use of technology, do you think it is time to encourage a return to more long-term employment relationship thinking?Toggle DrawerResourcesSuggested ResourcesThe following optional resources are provided to support you in completing the assessment or to provide a helpful context. For additional resources, refer to the Research Resources and Supplemental Resources in the left navigation menu of your courseroom.Library ResourcesThe following e-books or articles from the Capella University Library are linked directly in this course:Pre-employment screening: Special report. (2009). HRMagazine, 54(2), 41–44, 46, 48, 50.Roberts, B. (2011). Close-up on screening. HRMagazine, 56(2), 22–29.Tyler, K. (2012). Undeserved promotions. HRMagazine, 57(6), 79.Weinstein, M. (2014). Paths to success: Responsibility vs. promotion. Training, 51(4), 26–29.Witham, T. (2010). Pre-employment screening. Credit Union Management, 33(5), 38, 40.Bednar, J. (2014). Tackling the gender wage gap. BusinessWest, 30(23), 53, 63.Equal pay timeline. (2014). Congressional Digest, 93(5), 2, 32.Pay equity overview. (2014). Congressional Digest, 93(5), 3–7, 32.Subminimum wage for persons with disabilities under fire. (2012). Payroll Manager’s Report, 16(10), 11–12.SHOW LESSCourse Library GuideA Capella University library guide has been created specifically for your use in this course. You are encouraged to refer to the resources in the BUS-FP4044 – Legal Issues in Human Resource Management Library Guide to help direct your research.Integrated MaterialsWalsh, D. J. (2019). Employment law for human resource practice (6th ed.). Boston, MA: Cengage. Available in the courseroom via the VitalSource Bookshelf link.Chapter 2, “The Employment Relationship.”Assessment InstructionsFor this assessment, write a 3–4-page analysis in which you complete the following:Describe each category of worker (full- and part-time employees, independent contractors, temporary employees, interns, students, volunteers, and partners).Include an analysis of the pros and cons of each type of worker, from an employer’s perspective.Select and describe a type of business. Describe the ideal proportion of workers (full- and part-time employees, independent contractors, temporary employees, interns, students, volunteers, and partners) and include a supporting rationale.
BUS 4044 Capella University Employment Category Analysis Question

If a decrease in the unemployment rate isn’t necessarily a sign of an improving.. I need support with this Economics question so I can learn better.

Unemployment
A country’s economic performance is measured using three key indicators, one of which is the unemployment rate. When adults who are willing and able to work cannot find a job, it may be a sign that an economy is producing less than it could. On the other hand, unemployment is also a natural phenomenon that even healthy economies experience. While the official unemployment rate is helpful in representing the state of a nation’s workforce, it does have some shortcomings that should be considered, such as excluding discouraged workers.
There are three types of unemployment that economists describe: frictional, structural, and cyclical. During recessions and expansions, the amount of cyclical unemployment changes. Cyclical unemployment is closely related to the business cycle, and causes the deviations of the current rate of unemployment away from the natural rate of unemployment.
The labor force participation rate (LFPR)
The labor force participation rate (LFPR) is another measure of labor market activity in the economy. The LFPR is the percentage of the adult population that is in the labor force. The labor force includes everyone who is either employed or unemployed. The adult population is defined as anyone who is over the age of 16 who potentially could be part of the labor force. Anyone who is less than 16 years old, is in the military, or is institutionalized is not considered to be potentially part of the labor force and is excluded from this calculation.
When people enter the labor force the LFPR increases, and when people exit the labor force the LFPR decreases. A decrease in the LFPR that occurs at the same time as a decrease in the unemployment rate can signal that there are more discouraged workers.
Limitations of the unemployment rate
The unemployment rate as it is measured officially is often criticized for understating the level of joblessness because it excludes anyone working at all or people who aren’t looking for work. In particular, the official unemployment rate leaves out discouraged workers and the underemployed. People who have given up looking for work because they are convinced that they cannot find jobs are considered discouraged workers. Some people are counted as employed because they are working part-time, even though they really want full-time work.
Three types of unemployment
Economists primarily focus on three types of unemployment: cyclical, frictional, and structural. Cyclical unemployment is the unemployment associated with the ups and downs of the business cycle. During recessions, cyclical unemployment increases and drives up the unemployment rate. During expansions, cyclical unemployment decreases and drives down the unemployment rate.
The natural rate of unemployment
The natural rate of unemployment (NRU) is the unemployment rate that exists when the economy produces full-employment real output. NRU is equal to the sum of frictional and structural unemployment. When an economy is producing an efficient amount of output (meaning it is operating on its PPC), the unemployment rate will be equal to the natural rate of unemployment. Even though an economy may be operating efficiently, there will still be some unemployment. Because of that, the natural rate of unemployment is never equal to zero.
Changes in the natural rate of unemployment (NRU)
The natural rate of unemployment (NRU) can gradually change over time due to events such as changes in labor force characteristics. The NRU can change due to changes in structural and frictional unemployment. For example, a firm may want to hire fewer workers because the skills of those workers are not needed as much as they used to be. That will cause more structural unemployment, and the natural rate of unemployment will increase.

Explain with relevant data sources from https://www.statista.com/statistics/262524/unemployment-rate-in-saudi-arabia/ .
If a decrease in the unemployment rate isn’t necessarily a sign of an improving.

University of Maryland Social Work Proposed Program Evaluation Report

University of Maryland Social Work Proposed Program Evaluation Report.

To ensure the success of a program evaluation, a social worker must generate a specific detailed plan. That plan should describe the goal of the evaluation, the information needed, and the methods and analysis to be used. In addition, the plan should identify and address the concerns of stakeholders. A social worker should present information about the plan in a manner that the stakeholders can understand. This will help the social worker receive the support necessary for a successful evaluation.To prepare for this Assignment, identify a program evaluation you would like to conduct for a program with which you are familiar. Consider the details of the evaluation, including the purpose, specific questions to address, and type of information to collect. Then, consider the stakeholders that would be involved in approving that evaluation. Review the resources for samples of program evaluations.By Day 7Submit the following:A 1-page stakeholder analysis that identifies the stakeholders, their role in the agency and any concerns that they might have about the proposed program evaluationA 2- to 3-page draft of the program evaluation plan to submit to the stakeholders that: Identifies the purpose of the evaluationDescribes the questions that will be addressed and the type of information that will be collectedAddresses the concerns of the stakeholders that you identified in your Stakeholder Analysis
University of Maryland Social Work Proposed Program Evaluation Report

BUS 350 AU Global Emerging Markets Huawei Chinese Multinational Company Report Essay

assignment helper BUS 350 AU Global Emerging Markets Huawei Chinese Multinational Company Report Essay.

TEN PAGE SINGLE SPACED PAPER IN 12 INCH TIMES NEW ROMAN FONT. Some (but not all) of the elements included in this project may include:1.Picking a Start-up Business within a specific Country from the region theProfessor assigns you2.The “Entrepreneurial ecosystem” of your country based on the region you wereassigned?3.The problem your Company that you are covering solves4.Cultural implications of the product within the country. Why it matters from acultural perspective.5. Analysis of the Human Capital (Education, resources, access to information)6. Personas/customer/demographic that are targets for the company you arecovering.7.Companies that you would consider “competitors within the region and why?”8. Innovations originating from your country/region and why these might be unique to that area9.Companies from your chosen country/region and why they are unique to that area10.Scalability of the product within your region11.What has the success factor been, in terms of customers, dollars, distribution, etc
BUS 350 AU Global Emerging Markets Huawei Chinese Multinational Company Report Essay

Remote Deposit Capture Project’s Risk Plan Essay

This document acts as an initial risk plan tool for Remote Deposit Capture project. Basically, it provides a thoughtful plan of the project in order to prevent problems that may pose a nightmare during its implementation. Such risks must be adequately monitored, more especially, where they are deemed to pose serious threats to implementation of the project (Cooper

Queens College Technology Investments in Movies Discussion

Queens College Technology Investments in Movies Discussion.

Part A::: Review the module resources and overview, and select a popular-culture example (television show, commercial, game, movie, etc.). Analyze how technology is represented and the social message conveyed by the example. In your initial post, briefly describe the popular-culture example you selected and address the following:How does your example portray or reflect technology?What is the social message or commentary about technology reflected by your example?How does a study of technology illuminate or enhance your experience of the example?Material/Resources: 1. https://sk-sagepub-com.ezproxy.snhu.edu/reference/the-sage-handbook-of-social-media/i3018.xmlPart B::: In responding to your peers, provide feedback about the example utilized and the message/commentary about technology being provided. What would you add to their analysis?Peer 1 Post: My choice for pop-culture reference would be the MCU’s Black Panther. Much like films throughout the entire MCU franchise the film depicts a world in a fictional country on the African continent where the use of a unique natural resource enables the country to develop advanced technology that allow for renewable resources, advanced defenses all fictional of course, but similar to the reference to Star Trek, the fictional technology presented though imaginative could one day be real. What I find to be unique about the film is that the idea of this mineral that can only be found on the African continent is parallel to the mining and use of mineral like cobalt and coltan which produced technologies like the smart phone and tablets. However, in the film the depiction of a nation that protects its natural resources and has not faced exploitation and human rights violations.Personally, I feel that the study and development of technology has helped me understand what technology is. While its description may include smartphones there is also the inclusion of the gas pump handle or the many uses of silicone.Peer 2 Post: For my discussion I am going to use my favorite movie, . The movie stars Helen Hunt and Bill Paxton as scientists chasing tornadoes through the Oklahoma Plains. They use this instrument pack called “Dorothy”. The significance of “Dorothy” is that the pack can give scientists a whole bunch of data to study tornadoes and can advance the times sirens start by at least 15 minutes. This movie is significant because of the instrument pack and what it can do when it comes to tornadoes and warnings. Though this movie is somewhat factious, its based off of a real thing. Twister is based off of the NOAA project called (coincidentally) TOTO. TOTO was an instrument pack similar to “Dorothy”. The significance of this is technology helped the scientists better understand how tornadoes function and work. Though I do not think to the extent of what “Twister” did, but it did help scientists understand severe weather to better the scientific world. Studying technology and how it can function is important. Researching can give you information on what was found out during the project and how they used the information to improve their understanding.
Queens College Technology Investments in Movies Discussion

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