...Critical Appraisal of Guideline Critical Appraisal of Guideline Appraisal Tool The tool chosen to appraise the guideline is called the AGREE II (http://www.agreetrust.org/). The purpose of the AGREE II is to examine the quality of guidelines through a step-by-step approach as to what and how information is presented in a guideline. The step-by-step approach is completed via twenty three steps which are categorized into 6 domains. Domain one addresses the overall scope and purpose of the guideline. Domain two is concerned with the stakeholders’ involvement and how the intended users view the guideline. Domain three pertains to the rigor of development of the guideline through eight steps which cover the method of evidence synthesis. Domain four deals with the clarity of the presentation throughout the guideline. Domain five is titled applicability, and it focuses on barriers and facilitators in applying the guideline. Domain six is titled editorial independence and evaluates whether the guideline is free from biases. Guideline The guideline chosen for appraisal is Diagnosis and management of headache in adults. A national clinical guideline (http://www.guideline.gov/content.aspx?id=13446#Section396). Critique Domain one: The guideline presents evidence-based recommendations for the diagnosis and management of headaches in adults. The health questions covered by the guideline are located in the annex of the ¬¬¬¬¬original guideline, and the target population, interventions...
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...Neurobiology Discuss 2 different neurological disorders that can occur in development and how they affect development. In addition, discuss what research suggests about the effects of spiritual disciplines (prayer, meditation) on neurobiology. What is Neurological disorder? According to Early Support and Cabrera, our brain development begins during pregnancy and continues through adolescence. We are born to have trillion connections by each nerve cell (neurons) and are not developed until infancy. Brain, spinal column and nerves are all involves in neurological disorders. Neurological disorders are wide ranging, it has various causes, complications, and outcomes. There are several cases of neurological, according to first sign organization the most common neurological disorder is mental retardation and autism spectrum disorder considered as the second most common disorder. Mental retardation occurs during childhood. This disorder is considered as a disability. It limits our intellectual functioning and adaptive skills. It affects the development of communication, conceptual skills, social skills, self-care, home living, social skills, self-direction, community use, health and safety, functional academics, leisure and work. The intervention strategies are to promote the development, education, interest, and personal being. As well as providing distinctive supports can improve personal functioning, promote self-determination, social inclusion, and personal well-being...
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...increased muscle tone, or resistance to passive stretch is at least initially caused by exaggerated stretch reflexes (Ranatunga 2011). Muscle spasticity often leads to muscle contractures that limit range of movement and cause increased muscle stiffness but the reasons for this adaptation is unknown (Smith et al 2011). Serial casting is a non-invasive procedure that helps children and adults improve their range of motion so they can perform daily activities with less difficulty. It is a process in which a well‐padded cast is used to put a joint out of action when it is unable to go through full range of movement. Casts are usually removed and reapplied on a weekly basis. Each cast gradually increases the range of movement in the affected joint. (Pohl 2002) Serial casting involves immobilization of a muscle in a lengthened position for a prolonged period of time, thereby gradually increasing the extensibility of the muscle and surrounding soft‐tissue structures. The mechanism by which this process occurs has been theorized to be an increase in both the length and the number of sarcomeres in the target muscle (Gajdosik 2001), (Robert 2004) Children with cerebral palsy often have a combination of contracture and spasticity in their gastrocnemius, the muscle that’s mainly responsible for plantarflexion of the foot, and this can cause an equinus gait (Graham HK. 2001). A study conducted by Ackman et al in 2005 looked into comparing casting with Botulinum toxin A for the treatment of...
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...DISEASES in the BRAIN -Locked-in Syndrome http://www.cdrex.com/ -is a condition in which a patient is aware and awake but cannot move or communicate verbally due to complete paralysis of nearly all voluntary muscles in the body except for the eyes. Total locked-in syndrome is a version of locked-in syndrome where the eyes are paralyzed as well.A rare neurological disorder characterized by complete paralysis of voluntary muscles in all parts of the body except for those that control eye movement. It may result from traumatic brain injury, diseases of the circulatory system, diseases that destroy the myelin sheath surrounding nerve cells, or medication overdose. Individuals with locked-in syndrome are conscious and can think and reason, but are unable to speak or move. The disorder leaves individuals completely mute and paralyzed. Communication may be possible with blinking eye movements. -Tourette's(http://tourettecamp.com/index.php) syndrome is an inherited neurological disorder. Early onset may be during childhood, and is characterized by physical tics and verbal tics. The exact cause of Tourette's, other than genetic factors, is unknown. -Huntington's(http://huntingtonsaustralia.asn.au/)& http://www.huntingtonsociety.ca/english/content/?page=Staff%20Bio, http://www.hdsa.org/about/our-mission/what-is-hd.html Huntington's Disease: a devastating, hereditary, degenerative brain disorder for which there is, at present, no cure and only one...
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...felt at the back. The medical term for this type of pain is referred pain as it emanates from other body organs onto the back. Other disorders of the abdomen such as kidney disease, fibroids, urinary tract infections, ovarian infections, endometriosis and pelvic also causes pain that is referred to the back (Szpalski, 2010). Expectant mothers also experience back pain that is manifest in many ways. These include irritating nerves, strains in the low back and stretched ligaments within the pelvis. In pregnant mothers, these are often caused by the hormones estrogen and relaxin (Tulder, 2005). With appropriate medication and conservative management, the recurrence of acute back pain can be minimized. However, back pain that is caused by neurological disorders, rheumatologic diseases, infections and malignancy is dangerous and...
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...usually caused by brain injury, such as impairment of muscle tone, gross and fine motor function, balance, control, coordination, reflexes, and posture . Difficulties in swallowing and feeding, speech impairment, and poor facial muscle tone may also indicate cerebral palsy. Other conditions that are not a result of brain injury include sensory impairment, seizures, and learning disabilities. Disabilities may only apply to one limb or side of the body, and in other cases, may affect the entire body. These conditions will not change over time, and usually don't shorten with age. Many muscle problems may worsen over time, or cause other problems in the future unless they are treated. When it comes to helping children with musculoskeletal and neurological difficulties, it may require physicians to tackle multiple symptoms that their patients may have. Issues usually include difficulties with eating, cognitive function, perception, and perhaps more depending on the severity of the child. The trigger for cerebral palsy is unknown. There are many factors that may lead to problems with the brain development such as random mutations, maternal infections, fetal stroke, lack of oxygen, infant infections, or traumatic head injuries. Cerebral palsy and its effects on people cannot be explained by just severity alone. It has been shown that environmental factors may also affect the situation . There are extrinsic factors that are unique to the individual, such as physical and material features...
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...Bell’s Palsy is named for Sir Charles Bell, a 19th century Scottish surgeon and physiologist who described the facial nerve and its connection to the condition. The disorder, which is not related to a stroke, is the most common cause of facial paralysis. Generally, Bell’s Palsy affects only one of the paired facial nerves and one side of the face, however, in rare cases it can affect both sides. (NIND,2003) It’s sudden onset, the cause is unknown but is presumed to involve swelling of the seventh (facial) nerve due to immune or viral disease resulting at the point where it leaves the bony tissue. (Davis, 1985) Due to the inflammation that is directed by the body’s immune system against the nerve controlling movement of the face. This causes one side of the face to droop and the eyelid can have difficulty closing properly which then can lead to dry eye and other eye issues. Here is some disease linked to it, diabetes, high blood pressure, multiple sclerosis and viral infections such as herps simplex, which causes cold sores and genital herps. The incidences of bell’s palsy vary between 20 and 30 percent 100,000 people per year it accounts for 60-75% of all acute peripheral facial palsy. The male/female ratio for bell’s palsy is approximately equal. The median age at onset is 40 years, but the disease may occur at any age. The incidence is lowest from the ages of 10 – 59. (Slatter,etal2014) Bell’s palsy is usually diagnosed based on your symptoms and a physical examination. Blood...
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...People with cerebral palsy deal with an assortment of physical issues, but not everyone with cerebral palsy is going to experience the same symptoms. Some people have mild cerebral palsy. While they may have a limp, they are able to walk on their own. They may experience a few other minor physical disruptions, but in general, they are able to perform daily activities on their own. Those with moderate cerebral palsy may need braces, medication, and other adaptive devices to perform daily tasks. Those with severe cerebral palsy will require a wheelchair. They will face significant challenges in performing other tasks. Each person with cerebral palsy faces their own set of unique physical challenges, but here are a few physical challenges many people with cerebral palsy experience. Balance For many people with cerebral palsy, balance is a major issue. People with cerebral palsy often struggle to stand or walk, especially without assistance. Those who can walk may have an awkward gait. Their balance may be thrown off even more when the person tries to walk faster or run. Sitting up without assistance is difficult or even impossible for some people who have cerebral palsy. Spinal Deformities Unfortunately, some people with cerebral palsy experience spinal deformities, which may give the person a hunched or an otherwise curved back. This can also make walking, standing, or sitting difficult or painful. Unfortunately, the misalignment of the joints may put added pressure on the...
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...Tourettes Syndrome in Children Tourettes syndrome (TS) is a neurological disease which means it is in the brain. Although its specific cause is still under scientific investigation, it is believed that tourettes is caused by neurotransmitters in the brain which do not connect properly. It is a known fact this disease is genetic but it is usually not passed on by parents. It is also know that the disease can be influenced by ones environmental surroundings. Tourettes is diagnosed after 1 year of a person experiencing the symptoms. It begins in childhood and in most cases people grow out of it before adulthood. While tourettes’ exact cause is unknown, it is becoming more common and in severe cases it can interfere with every day life. Motor tics is the biggest side effect of tourettes and in severe cases it can cause interference. Motor tics can be vocal which may cause the person to grunt or hum. Motor tics may also be physical by causing the person’s body to have a sporadic, involuntary movement. This is due to muscle groups. In non severe cases the person is able to live a normal life, medication and therapy free because they may simply jerk their head or shrug their shoulders every so often. A person with a severe case of tourettes is unable to attend school and go about daily activities because their motor tics cause them to have more severe movements such as repeated head jerking or other movements. In rare cases...
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...The Research of Medical Marijuana: A literature Review One of the most controversial subjects not only in health care but also in the United States right now is medical marijuana. The subject of marijuana is not new to the U.S but medical marijuana is just beginning to evolve. Medical marijuana also referred to as cannabis, is meant to be a form of medical therapy to treat certain diseases and alleviate symptoms. According to a current research, “Cannabis has been used to reduce nausea and vomiting in chemotherapy and AIDS and to treat pain and muscle spasticity” (Werner, 2012) Since July 31st 2014 there are now 23 legal medical marijuana states and also DC. As many people know, Illinois has just joined on the medical marijuana bandwagon and legalized it in 2013. Becoming a nurse, the use of medical marijuana is going to keep growing and there is still a large amount of research and studies to be done on the subject. Efficacy and safety of medical marijuana in selected neurologic disorders Researches Koppel, Brust, Fife, Bronstein, Youssof, Gronseth, and Gloss came together to focus on how medical marijuana would affect people with neurologic disorders. The main purpose in this study is to determine the efficiency of medical marijuana in several neurologic conditions. One of the most common neurologic disorders seen is multiple sclerosis; which is an autoimmune disease that affects a person’s brain and spinal cord. (Koppel, et. al, 2013) Key points The question the authors...
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...felt at the back. The medical term for this type of pain is referred pain as it emanates from other body organs onto the back. Other disorders of the abdomen such as kidney disease, fibroids, urinary tract infections, ovarian infections, endometriosis and pelvic also causes pain that is referred to the back (Szpalski, 2010). Expectant mothers also experience back pain that is manifest in many ways. These include irritating nerves, strains in the low back and stretched ligaments within the pelvis. In pregnant mothers, these are often caused by the hormones estrogen and relaxin (Tulder, 2005). With appropriate medication and conservative management, the recurrence of acute back pain can be minimized. However, back pain that is caused by neurological disorders, rheumatologic diseases, infections and malignancy is dangerous and...
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...Nathan Perry is a ten-year-old boy who suffers from cerebral palsy. This disease causes him the inability to perform normal actions that the majority of people do not give a second thought. He is in need of a surgery before he hits puberty and starts having massive growth spurts. There is a surgery that could possibly help him, but the cost may not make it possible for him to have it (Sydney). The cause of cerebral palsy is usually the same, there are multiple symptoms that occur, and though there is no cure, there are several ways to help treat it. Cerebral Palsy (CP) is commonly caused by a brain injury in the fetus, such as lack of oxygen before, during, or even after birth. Though research has found that in about 1 in 10 cases the cause...
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... Sullivan et al, 200710 They states that, the term Hemiplegia is often used generically to refer the wide variety of motor problems that result from cerebro vascular accidents. Clinically, there is a possibility of variety of focal deficits, including changes in the level of consciousness and impairments of sensory, motor, cognitive, perceptual, and language. Mariam AG et al, 198318 From 1978 to 1982, 50 consecutive cases of acute infantile and childhood hemiplegias were followed up at their Neurology clinic. Fifteen cases (30%) were below the age of two years and 34 cases under five years of age (68%). Their youngest patient was six months and the oldest 13 1/2 years. The male to female ratio was 1.3:1. An acute onset of hemiplegia was noted in 64% of cases. A right side hemiplegia was more common than a left (1.5:1). Idiopathic cases, where no clinical associations could be made, bacterial meningitis, head traumas, and encephalitis were the four leading causes of acute hemiplegias in our series. (A complete recovery was noted in 82% of cases without associated clinical causes.) Subsequent development of epilepsy was noted in 10% of cases at follow-up. Kim et al, 201219 This study aims that to determine the associating factors of fear of falling (FOF) and the correlations between FOF and quality of life (QOL) on subacute stroke patients in Korea. Fifty hemiplegic subacute stroke patients in their clinic were recruited. They directly asked patients with their fear of falling...
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...Bell palsy What is Bell palsy? Bell palsy is a neurologic disorder characterized by dysfunction of cranial nerve VII, the facial nerve. Individuals typically develop one sided facial weakness that may be associated with altered saliva and tear production on the same side as facial weakness. Individuals may also experience loss of sensation in the anterior two-thirds of the tongue. Most individuals experience a full recovery, however, a subset of patients have permanent facial weakness. This may lead to psychological symptoms and disability. Eye lid involvement can result in the inability to close the eyelid. Individuals often require frequent use of eye lubricants and referral an eye specialist. Lower facial muscle involvement can lead to drooping of the corner of the mouth and slurred speech (dysarthria). These symptoms are often mistaken for stroke. Patients often require referral to a speech and language therapist. Due to the importance of this condition, it is critical that patients understand its causes, symptoms, and treatment. By the end of this article, you will have the answers to these essential questions: • What causes Bell palsy? • How common is Bell palsy? • What are the symptoms and signs of Bell palsy? • How is Bell palsy diagnosed? • How is Bell palsy treated? What causes Bell palsy? The precise cause of Bell palsy is uncertain, however, there is some evidence to suggest that herpes simplex virus activation is related to its pathogenesis. The virus...
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...helps relieves muscles in your head which helps the headache. Migraines have effects on the brain stem. If migraines are painful enough it can cause brain stem infractions. Although migraines cannot cause permanent damage to the brain. Exercise that causes adrenaline can help make migraines go away. Headaches and migraines can be caused by cerebrovascular accidents. People don’t know what yet exactly causes headaches. It may be caused by nerve cells on the brain. It also can be over stimulated blood vessels, which leads to inflammation. Estrogen and progesterone can cause migraine and headache in women. Migraines can be hereditary and can be passed down. Migraines cannot cause disability to the brain. Scientist says migraines can be neurological disease. Migraines are on one of the most mistreated disease. Women with migraines are seven times more likely to have an ischemic stroke. Migraine can cause a block in an artery which can trigger the...
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