Diabetes Type II and Oral Hygiene
In patients aged 30–60, how can maintenance of oral hygiene by developing an oral health strategic plan as opposed to merely maintaining good hygiene (e.g., flossing, brushing teeth, etc.) influence the reduction of the diseases such as gingivitis, periodontitis, etc., over a year at most?
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According to the current U.S. statistics, diabetes remains the greatest threat to people of all ages due to the lack of information on the subject matter, especially regarding its causes and the factors that promote its development (American Diabetes Association, 2016). However, apart from being a serious health issue on its own, diabetes affects a range of organs, therefore, causing patients to develop a range of health complication, such as kidney diseases (Qaseem, Centor, & Dunn, 2014). Although the problem concerning the gum disease is not the most serious threat to the patient’s health, the deterioration of the latter’s teeth may serve as the foundation for the emergence of gastroenterological disorders, which, in their turn, will serve as severe complications.
The lack of awareness concerning the link between the oral hygiene maintenance and the development of diabetes of both types is surprisingly low. Researches show that, although most denizens of the U.S. population tend to take care of their teeth in a proper manner, they are unaware of the link between diabetes and the gum disease). Herein the urgency to spread awareness concerning the issue lies, and nurses will play a crucial role in it.
Studies also point out that there may be a mutual connection between the gum disease and diabetes (Snyder, 2015). Among the primary proofs for the given statement, the fact that poor oral hygiene permits bacteria to affect the glucose level in the patient’s blood, therefore, causing diabetes to develop. While it should be borne in mind that the actual origins of diabetes of both types are not yet known to the humankind, the factor under analysis should till be viewed as a cause for concern, and the significance of proper oral hygiene should be promoted to all denizens of the target population:
There is a two-way relationship between gum (periodontal) disease and glycemic (sugar) control in people with diabetes. Individuals with diabetes are at much higher risk of developing gum disease, and chronic inflammation and infection from periodontal disease can make it more difficult to control blood sugar levels. (Snyder, 2015, pp. 2-3)
However, there is no need to stress that the traditional oral hygiene strategy used in everyday life still allows for the risks to exist. Particularly, brushing, flossing, and regular visits to the dentist, while reasonable and sound pieces of advice, still allow for a sufficient amount of risk. Therefore, a more elaborate strategy for preventing the problem from developing needs to be designed. The goal can be attained by designing an oral health strategic plan that will later on serve as the foundation for developing healthy oral hygiene habits and blocking possible factors of diabetes development from affecting the patient’s health.
One must admit that the above-mentioned oral health plan will not eliminate the threat of gum disease emergence, as the specified health concern is intrinsically linked to diabetes (including both type I and type II). Therefore, the patient must maintain the oral strategy above throughout their life as the tool for blocking the disease from progressing. Therefore, it is the role of a nurse to make sure that the patient should be raedy to battle the gum disease through the rest of their life.
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Studies also point to the fact that the maintenance of oral hygiene in accordance to a plan previously created by a nurse may also serve as the means of reducing the threat of diabetes (type I and 2) from occurring (Nagpal, Yamashiro, & Izumi, 2015).It is suspected that the bacteria contained in the dental area that has not been cleaned properly serves as the breeding ground for blocking glucose and sugar from entering cells (Snyder, 2015). Seeing that the inability of cells to absorb sugar can be defined as the start of diabetes as a health issue, it is essential that the bacteria accumulating in the patient’s mouth should be prevented from entering the bloodstream.
As it has been stressed above, the nurse’s role in the specified issue concerns, though is not restricted to, the development of an elaborate oral hygiene plan that will serve as the set of active therapeutic measures (Nagpal et al., 2015). Particularly, RNs and APRNs should consider the development of the program that will help raise awareness regarding the subject matter and convince the target audience (including the patients with gum disorders and the ones with diabetes of either type) to consider the adoption of the program above. It is strongly recommended that the program in question should incorporate the aspects such as the provision of the necessary information and resources, the consultations provided by nurses, and training the skills required for blocking the existing threat from affecting people’s health negatively. The significance of guidance and consultations provided by nurses cannot possibly be overrated in the given scenario. While some of the pieces of advice provided by nursing consultants may seem a common knowledge, researches point to the fact that the people with diabetes who are under a consistent supervision of nurses show fewer instances of serious gum disease development than those who are home-treated: “Not surprisingly, prevalence of BMI values over 25.0 kg/m was higher in DMRs. Meanwhile, DMRs suffered less frequently from dehydration, mouth pain, and gum inflammation, and these conditions were rare in both groups of residents” (Szczerbinska et al., 2014, p. 3), where DRMs are the patients that are under a constant supervision of a nurse (i.e., are the diabetic residents of a nursing home).
In other words, it is imperative that a well put together, comprehensive plan for a proper oral hygiene should be created for each patient individually by a nurse. The provision of the specified plan is not dependent on whether or not the patient has diabetes, though the presence of the latter should definitely serve as a catalyst for creating the plan within the shortest amount of time possible. It is assumed that the identification of the crucial elements of the plan in question as well as the development of the form that needs to be filled in whenever there is a need for a nurse to design a personal dental care plan must be prompted and completed within a year at the most. Thus, it may become possible to develop a preventive measure against not only a common dental issue but also the development of diabetes type I, i.e., the disorder that is currently affecting the life expectancy of people all over the world.
Cardiovascular Diseases (CVD): Addressing the Issue
In patients aged 20–60, will the introduction of new mobile phone applications as the tools for requiring urgent nursing services will help reduce the CVD mortality rates compared to the currently applied tools, e.g., emergency calls, and improve the existing issue regarding the nurse workplace burnout as opposed to the use of rescheduling, within a year?
Though technically not a brand new issue that has only recently been caught on the nursing radars, CVD remains one of the key causes of death all over the world, in general, and in the United States, in particular (Yang et al., 2012). According to a recent data, the rates of CVD patients have increased drastically over the past few years (Mozaffarian et al., 2015); therefore, it is imperative that the corresponding nursing strategies could be provided to manage the problem under analysis.
A closer look at the subject matter will reveal, however, that there has been a consistent drop in the efficacy and quality of the services provided by nurses to the target denizens of the population. Indeed, according to the latest statistical data, the age threshold for the patients developing CVD and the related disorders has been dropping greatly over the past few years: in 2009–2012, the number of CVD patients among men and women aged 20–39 made 11.9% and 10% correspondingly (CDC , 2015). Therefore, the issue deserves a closer attention and the introduction of innovative methods of managing the issue.
Particularly, the adoption of applications as the means of improving the quality and, particularly, the speed of the corresponding nursing services should be discussed. On the one hand, the usage of the specified tool may help younger patients, who are apt to acquire the corresponding skills of using the apps (Stephens & Allen, 2013). Moreover, the apps may serve as the means of getting essential information across to the target patients so that the instances of CVD-related disorders, such as a heart failure, could be prevented successfully. On the other hand, the introduction of the application under analysis may trigger certain problems among the older denizen of the population, since they are unlikely to acquire the necessary skills of managing the application as fast as the younger ones will.
It could also be argued that the given innovation is likely to relieve the nurses of a significant amount of pressure that they are subjected to on a regular basis. Studies show that numerous authorities across the state have not only failed to vanquish the issue of the nurse workplace burnout but also aggravated the situation by introducing the changes that have only put a stronger strain on the healthcare experts (Bogaert et al., 2013). As a result, the problem regarding the workplace burnout among nurses remains a topical issue.
While the problem concerning the increase of CVD problems, the mortality rates induce by them, and the issue of nurse workplace burnout might seem unrelated, there is a very strong and complex connection between the factors under analysis. To be more exact, the consistent strain that nurses are to work under causes them to lose focus and to fail to deliver the services of the required quality, reports and researches show (Laschinger, Wong, & Grau, 2013). An increase in the workload that nurses have to deal with affects their concentration, making them lose focus and fail to take every single factor into consideration when diagnosing a health issue, running a test, defining the further course of treatment, checking the patient’s progress, tracking their daily intake of medicine, etc. Consequently, the use of the IT tools that may take an impressive amount of pressure off of them a is likely to make a difference in the designated area by creating the environment, in which nurses can respond to each case in a manner as efficient and expeditious as possible. Particularly, the use of apps will help respond of the patients fast and, most importantly, get the current priorities straight by classifying the cases based on their urgency and the severity of the issue to be addressed (Stephenson, 2015).
One must admit that the introduction of applications into the nursing environment is likely to take an impressive amount of time. At present, there are three key obstacles to overcome so that the application could be incorporated into the framework of the nursing services operations, i.e., the social, the technological, and the financial ones. Fist and most obvious, training courses must be created for nurses in every major healthcare institution so that the staff could learn the necessary skills and apply them in an appropriate manner. Next, a similar process must be carried out among the target members of the population and, possibly, their caregivers, so that the patients could ask for the required nursing services and receive them promptly. Te issue under analysis is admittedly more complicated when it comes to addressing the needs of elderly people as they are unlikely to train the necessary skills within a relatively short amount of time. The application, however, will help address the issue regarding the increasing rates of CVD development among younger patients (people aged 20–30); researches point out that he specified denizens of the population are likely to gain the necessary skills comparatively easily an promptly. Furthermore, the development of the application will require the usage of the latest technology and the acquisition of the devices that will help track down the instances of CVD crises so that the latter could be managed adequately. Last but definitely not least, the fact that the specified measures will require a substantial amount of financial resources deserves to be mentioned as a major hindrance on the way to improving the services. Despite the recent breakthrough in the area of nursing research, the funds received by the facilities can be defined as rather scanty ; therefore, the reconsideration of the budget of the facilities and the adoption of a new cost-efficient financial strategy will be necessary to provide patients with the services that they need.
The phenomenon above can be explained by the lack of motivation among the nursing specialists. The latter issue, in its turn, can be viewed from several perspectives. First and most obvious, the problem of nurse burnout needs to be mentioned. Typically defined as the fatigue caused by the enormous workload, the phenomenon of a workplace burnout manifests itself in nurses in the unwillingness to strive for the patient’s wellbeing and act for the benefit thereof. The issue in question is usually induced by an enormous amount of workload and can be solved by reconsidering the roles and responsibilities among the nursing staff in the local healthcare facilities as well as hiring new staff members.
Apart from weariness, however, the lack of motivation can be explained by the absence of personal development opportunities, particularly the premises for lifelong learning and the acquisition of new skills. Herein the need to introduce the nurses addressing the issue of CVD to a new training course lies; with the provision of new information sources and the possibility of acquiring new skills as well as training them successfully, nurses are most likely to feel valued and, thus, learn new information more actively to apply the newly learned skills in the workplace setting (Stephenson, 2015).
Studies also show that the lack of motivation among nurses to provide patients with the required CVD-related services and information is rooted deeply in their low self-esteem and the realization of their professional stagnation: “If nurses take a more active role in implementing best practice then that could have a hugely positive effect” (Stephenson, 2015, par. 3). Therefore, it is assumed that a CVD program that will provide nurses with a toolkit for managing CVD-related issues in a timely and efficient manner is highly likely to have a massive positive effect on the CVD development rates among the target members of the population.
Vision Loss: Causes and Therapy
In patients aged 25–60, will the strategy for coping with vision loss based on the involvement of family members into the process have a better effect on the patients with impaired vision compared to the strategy presupposing the provision of support from the hospital nurses within two years?
Although the phenomenon of vision loss cannot be deemed as something out of the ordinary and may even seem not as heavy a problem as the rest of the current concerns are, it still affects people’s lives significantly, and the recent reports show that the issue has been growing increasingly larger over the past few years.
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While the very concept of vision loss might seem far too broad, there has been a major issue brewing over the past few years in the U.S. society regarding the subject matter that narrows the problem down to a single issue. Particularly, the use of coping techniques for the patients suffering from a vision loss or severe vision impairment needs to be identified so that they could reintegrate back into the society successfully. The possibility of the patients’ self-image distortion and the emergence of depression-related tendencies is the key issue to beware in the designated scenario; several studies show that people with a vision loss are highly likely to develop a severe depression or similar psychological disorders: “Vision-specific distress may be an important predictor of depressive symptoms in people with visual impairment” (Barua et al., 2013, p. 8). Surprisingly enough, the subject matter has not been studied in an ample manner yet , although the significance of preventing depressive and suicidal thoughts in the members of a community can be viewed as an essential part of a nurse’s job.
Studies also point to the fact that there is a strong need to coordinate the process of coping with the patients’ depression and the strategies used to avoid the further aggravation of the problem. Particularly, a nurse must make sure that the process of adapting toward the loss of sensory abilities, vision being the case in point, a patient should comply with the existing rules concerning the prevention of the further complexities development. It is strongly suggested that the nurse should incorporate the information concerning maintaining the current vision abilities in case the patient has not lost their eyesight completely. Particularly, the nurse should provide the patient with the following instructions:
To maximize your visual capabilities in the home, increase the level of light by using a higher watt light bulb and evenly distribute or balance the light sources to eliminate glare. Finally, remember the value of getting regular eye checkups to assess your eye health. (Kemmet & Brotherson, 2015, p. 2)
Although the importance of family in the provision of support that will help the patient cope with the shock may seem obvious, a range of nurses overlook the opportunity of inviting family members to participate in the rehabilitation of the patient (Mouziraji, 2015). On the one hand, the reasons for nurses to avoid the seemingly simple solution is quite basic: without knowing the specifics of addressing the patient’s needs, family members may disturb the latter and affect the patient’s fragile self-image in a most deplorable fashion.
The incorporation of the support that family members and relatives can provide is likely to serve as an impressive boost for the patient’s confidence and, therefore, galvanize the recovery process. Scholars recognize the threats of involving family members or significant others into the nursing process yet admit that the specified strategy has a strong potential: “it may be important to better involve significant others such as family members and friends in psychosocially framed programs and emerging research with low vision adults has revealed advantages and disadvantages of such an approach” (Heyl & Wahl, 2014, p. 330).
Therefore, it is imperative that the relatives of the patients should be introduced to the therapy process. However, prior to starting communication with the patient, the people involved will have to be instructed by a nurse regarding the correct behavioral patterns that will serve as the foundation for the patient’s recovery, the recommended conversation topics that will not upset the patient, therefore, preventing the aforementioned issue of depression from developing, etc. Hence, the need to create the training courses for educating relatives of people with vision impairment or loss on the necessary behavioral patterns that will be supportive and lead to the patient’s recovery.
It is strongly suggested that the program should start with informing the family members on what they should expect and what the current loss is, as most nursing specialists advise that “the interdisciplinary team must be able to give the patient and family a realistic trajectory of recovery as well as recommended options” (Kresevic, 2015, p. 10).
Seeing that the program under analysis is likely to take an impressive amount of time, a nurse involved in tending trot eh needs of a patient with a vision impairment or loss needs to incorporate the training process with the intervention program so that the family members could receive the necessary information as the patient socializes with them. One must admit that the specified approach is likely to trigger numerous risks such as the instances in which the family members will be unaware of the reaction that they are required to display or the message that they need to get to the patient across. However, with the supervision and guidance of a nurse, the issues in question are likely to be avoided or addressed adequately.
Breast Cancer: Fighting for Life
Does the use of dance therapy in breast cancer survivors allow for a faster recovery from the outcomes of the treatment compared to other types of intervention?
Unfortunately, years of research have not helped eradicating the threat to women’s health and even lives that breast cancer is (Azem et al., 2015). Although the ongoing study reveals numerous facts regularly, the existing data is still not enough to create a prevention tool. Nevertheless, numerous approaches to addressing the problem and detecting it at the earliest stages of development have been suggested over the past few decades. As a result, in the process of detecting and treating breast cancer has become comparatively easier and safer for the patient. The problem of adapting toward the changes that the surgery, chemotherapy, or any other method of managing the issue has left, however, persists and affects lives of all women that are or have been forced to fight the disease.
It should be noted, though, that the application of the specified approach does not presuppose the rejection of the rest of the tools that help a patient manage the process of adapting toward a new lifestyle. For instance, the significance of family or relatives’ support in the course of recovery is not to be underrated and, therefore, the given factor must not be taken out of the recovery process equation. For instance, studies show that cancer patients are especially prone to developing severe depressions, which means that they need the support of their family members or significant others in order to maintain a positive attitude and avoid developing a psychological complication: “Depression and cognitive dysfunction increase functional impairment, compliance with therapy and reduce quality of life . Like cancer, various diseases associated with significant inflammation show high prevalence rates of depression” (Jehn et al., 2016, p. 1). The specified phenomenon is typically referred to as impaired thinking, i.e., the inability to focus on positive aspects and the fixation on the negative outcomes that eventually leads to a serious psychological condition and the necessity to develop an intervention program.
Still, from the perspective of psychotherapy, dancing and other types of rhythmic movements are most likely to serve as a perfect foil for the breast cancer survivor to abstain from being pessimistic about their current state. The important thing about dance therapy is that it does not presuppose abstaining from experiencing negative emotions completely; instead, it offers viewing the current problems from a slightly different perspective therefore, allowing the patient to be objective about the current state of affairs: “Dance movement therapy adopts both verbal and nonverbal communication and endorses creative processes and aesthetic perspectives in viewing life and interpersonal relations” (Ho, Lo, & Luk, 2016, p. 2). Studies display that the method of dancing therapies especially efficient for the breast cancer survivors who are undergoing or have undergone radiotherapy.The existing evidence shows that dancing serves as a perfect tool for managing breast-cancer-related depression.
Numerous sources also claim that the above-mentioned approach, also known as the dance movement therapy (DMT) can be used to improve the quality of life in cancer patients in general. The statement above, therefore, presupposes that DMT does not necessarily require the radiotherapy setting and is in general supposed to address the self-esteem and attitude issues that the patients are experiencing after being diagnosed and facing the threat of death: “Dance movement therapy (DMT) is known for its positive physical and psychological effects and for improving the quality of life of breast cancer patients” (Ho et al., 2016, p. 3).
When it comes to defining the characteristics of the approach that make it so efficient for breast cancer patients aged 20–60 and, in some cases, even older women, the expressivity of movement as an integral part of the communication process deserves to be brought up. From the perspective of nonverbal communication, dancing can be viewed as another tool for the patients to express their emotions and address some of the psychological issues, particularly, fears, that they may be unwilling to face on their own: “Dance movement therapy adopts both verbal and nonverbal communication and endorses creative processes and aesthetic perspectives in viewing life and interpersonal relations” (Ho et al., 2016, p. 3). Hence, the use of dance therapy as the means of helping patients manage their emotions is not to be overlooked by nurses. At this point, the significance of DMT as the method of enhancing the emotional intelligence (EI) of the patients needs to be addressed. EI is a perfect tool for managing the stress and depression that a breast cancer survivor is after or in the process of the excruciating treatment (Gutierrez et al., 2015). Seeing that dancing involves the expression of the patient’s emotions in this case, it can be assumed that the adoption of the DMT approach is the first step that a patient makes toward developing a proper understanding of her emotions: “As it is expected that dance training will enhance the self-concept, quality of life and emotional intelligence, it can be used as a psychological intervention to help individuals to improve their self-concept, quality of life, and emotional intelligence” (Kapur & Rawat, 2016, p. 91).
The tool above is admittedly rather complicated to use in the setting of a healthcare facility; while some women with a breast cancer issue prefer to remain outpatients, most of them are provided with the necessary healthcare and nursing services at the corresponding locations. In other words, the DMT approach calls for the creation of a nursing program that allows women with a breast cancer issue engage in the activities that will help them avoid possible complications such as depression, self-esteem issues, distortion of self-image, etc.
There is no need to stress that the process of restoring one’s self-image or perception of one’s self is a lengthy process, the success of which depends on the personal characteristics of the patient as well as the external factors such as the family support, the current beauty standards, etc. Therefore, calculating the number of weeks, months or even years required for the patient to regain her self-esteem and have a good image of herself is barely possible. However, the adoption of the DMT tool as the means of helping the client see herself from a positive perspective (e.g., as strong, beautiful, etc.)
Zika Virus Awareness: Preventing the Hysteria
Will active consultations, as opposed to the provision of online information and information in booklets, help address the current turmoil about Zika and inform the patients on the early identification of the threat within two weeks?
The Zika epidemic is a graphic, if, perhaps, somewhat more dangerous, example of how the turmoil concerning a specific disease, while spreading across the state, literally paralyzes people instead of enabling them to act responsibly and learning more about the problem. According to the recent data, a significant amount of the U.S. population has contracted the virus, which is a threatening index; however, despite the obvious concern, very little percentage of the population knows how to identify the threat and address it. Herein the ore problem lies; in order to facilitate the environment, in which people could remain healthy and avoid contracting the virus, one has to consider active use of the existing information resources particularly, the latest ones, along with the provision of the required healthcare services.
Studies show that, among the areas that are currently under a consistent threat, “the Commonwealth of Puerto Rico, the US Virgin Islands, and America Samoa” (CDC, 2016, par. 2) should be mentioned. According to the existing data, the mosquitoes that carry the virus inhabit these states; therefore, numerous precaution measures must be taken in case of visiting the specified areas. Indeed, researches point to the fact that the disease is transmitted by mosquito bites. Therefore, extensive information must be provided to the target population concerning the threat of mosquitoes. Specifically, the people who travel abroad to the areas mentioned above should be instructed on how to act in the environment that can be described as risky.
In addition, studies show that the symptoms of the virus contraction are rather similar to those of developing influenza. Indeed, according to the latest data concerning the development of the Zika virus, “Commonly reported symptoms include: a low-grade fever, joint pain (with possible swelling, mainly in the smaller joints of the hands and feet), itching, rash, which is sometimes itchy, conjunctivitis (red eyes), headache, eye pain” (NHS choices behind the headlines, 2016, par. 1). The symptoms described above are very common for a range of other disorders and diseases; for instance, the Center for Disease Control and Prevention (CDC) warns that Zika manifests itself in the form that is similar to “dengue or chikungunya” (CDC, 2016, par. 2); therefore, there is a high possibility for misdiagnosing the problem. Moreover, the fact that the symptoms listed above are not specific of the health issues posing a serious threat, there is a high possibility that the patient will address a healthcare specialist at a comparatively late stage of the problem development, thus, causing numerous complications to emerge and hinder the treatment process to the point where it may become incurable.
Herein the significance of the nursing services lies. It is essential that the target residents of the U.S. population should be warmed about the threat and that the corresponding preventive measures such as avoiding insect bites should be applied. In addition, the fact that testing for Zika is currently a possibility needs to be made awareness of; according to the data provided by CDC, in case of suspecting the contraction, nurses should perform the reverse transcriptase-polymerase chain reaction (RT-PCR) on serum (Waggoner et al., 2014) on the patients so that the presence of the virus could be either confirmed or denied.
Therefore, nurses must point out to the people above that they should follow specific behavioral patterns when traveling abroad. Specifically, the use of mosquito repellants needs to be brought up as an essential piece of information that every citizen of the target areas should be aware of. Moreover, the information mentioned above needs to be represented to people by consulting them along with the provision of the necessary instructions I booklets, journals, magazines, etc. researches point to the importance of personal communication with a nurse: it is assumed that, once being introduced to a specific piece of information by a nursing consultant personally rather than with the help of traditional or modern media, people are more likely to take the information seriously and remember the patterns that they must take to remain healthy and avoid the threat (Musso, 2014).
In addition, awareness must be raised concerning the way, in which one should dress when appearing in the environment that can be characterized as threatening (i.e., in the areas where one is exposed to mosquitoes). Particularly, wearing long-sleeved shirts and long-legged trousers is strongly recommended. Furthermore, the use of mosquito beds and air conditioning as the essential tools for preventing the disease contraction need to be considered.
Despite the fact that there is no cure for the disease at present (CDC, 2016), numerous studies show that, by spreading awareness about the dangers of the virus and the possible sources of its contraction, nurses can bring the chances of an epidemic down to a considerable degree similarly to other deadly diseases that the humankind has faced over the past few decades, such as AIDS, cancer, diabetes, etc. According to the statistical data, promoting healthcare awareness allows for reducing the danger significantly (Roth et al., 2014). Therefore, the role of a nurse in bringing the above facts to people’s attention and, therefore, preventing the epidemic form erupting cannot possibly be underrated.
As for the tools for getting the message across to the target denizens of the population, studies point to the fact that personal consultations are likely to help patients get their priorities straight and evaluate the risks of contracting the virus from a reasonable angle. As researches mentioned above have shown, the provision of consultations will serve as the foundation for people to build their further knowledge about the problem on and to acquire the necessary behavioral patterns that will assist them in preventing the disease contraction.
Last but definitely not least, the adoption of the measures above (i.e., the use of personal consultations by healthcare experts in contrast to online counseling) should serve as the means of convincing people to take the risk seriously yet not to let the fear consume their entire lives. As a result, the hysteria around the subject matter can be prevented, and people are likely to make less mistakes when managing the issue. Consequently, the instances of Zika contraction are likely to be reduced in the target area significantly.
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