...1. Analysis of Research Report Paper Mary Ellen Strout HCS/438 Ann Impen April 11, 2011 2. Analysis of a Research Report Paper The article I chose was from the Annals of Surgery, called Multivariate Analysis of Risk Factors for Death Following Gastric Bypass for Treatment. I chose this article, because I did have this surgery done with no complications, and it is also a fascinating procedure and hope to one day work in this area. Pre operative mortality is the most feared outcome of bariatric surgery, it is reported to happen between 0.5 ad 1.5% of patients. In this article it identifies mortality fore either open or laparoscopic Roux-en-y bypass. The database is from Virginia Commonwealth university and was queried for patients who had undergone either an open gastric bypass (O-GBP) or a laparoscopic gastric bypass (L-GBP). A multivariate logistic regression analysis to identify factors related to perioperative mortality was performed. The factors examined included was age, gender, body mass index, preoperative weight, hypertension, diabetes mellitus, sleep apnea, obesity hypoventilation syndrome, venous 3. Analysis of a Research Report Article stasis ulcers, intestinal leak, small bowel obstruction, and pulmonary embolus. The data was found to find independent factors related to early death. Early death was defined as death that occurs within 30 days of the initial procedure or as a direct result of a complication of the original procedure (Annals...
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...Chapter 1 Introduction Disorders related to hypertension are one of the most common medical complications during the pregnancy. It is also an important cause of maternal and preinatal morbidity and mortality worldwide (Baha, 1996). The term hypertension in pregnancy describes a broad spectrum of medical conditions, for which the pressure in the blood vessels varies widely. According to studies conducted by WHO (2004), hypertension causes complications in 5 to 7% pregnancies in the United Kingdom. The risks associated with hypertension are high for pregnant women and they are higher risk for complications such as organ failure, cerebrovascular accident, abruptio placentae and disseminated intravascular coagulation (Mark, 1998). Also hypertension creates complications for the featus and it is at the risk or intrauterine growth retardation, prematurity and intrauterine death. Hypertension is also a major cause of maternal, fetal and neo natal morbidity and mortality, not only in developing but in developed countries also,(Pesola (2001). The rate of eclampsia in the UK have fallen recently, hypertension during the pregnancy remains one of the main causes of maternal death. According to a study conducted by NICE one third of maternal morbidity was caused as a result of hypertensive conditions. Hypertensive disorders also carry a risk for the baby. In the most recent UK perinatal mortality report, 1 in 20 (5%) stillbirths in infants without congenital abnormality occurred...
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...harder for blood to flow through. If a blood clot forms, it can stop the blood flow. This can cause a heart attack or stroke (“What is Cardiovascular Disease (Heart Disease)?”). The purpose of this paper is to discuss the risk factors associated with a previous client that I cared for in the clinical setting and to include rationale and some behaviors that could reduce these risks. The patient that I will be focusing on is a 56 year old female of polish descent whom I will refer to as I.G. She was admitted to UMC with a chief complaint of left knee pain. Her admitting diagnosis was a left distal femur fracture and has a medical history of congestive heart failure, hyperlipidemia, glaucoma, rheumatoid arthritis, hypertensive disorder, GERD, and diabetes. She admitted that diabetes runs in her family and she also has a history of smoking and obesity evidenced by her BMI of 32.1. Diabetes Diabetes Mellitus is associated with a reduced life span, largely as a result of cardiovascular disease and most patients die as a result of a thrombotic event. Patients with diabetes are at increased risk for CVD. This risk affects women more than men and is influenced by the client’s ethnic group. Patients with diabetes often also have the cardiovascular risk factors of obesity, hypertension, dyslipidemia, and sedentary lifestyle. Cigarette smoking and a positive family history also greatly increase risk of CVD (Ignatavicius &Workman, 2013, p. 1413-1414). Because of her family history...
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...Controls 25. iii) Results 27-36. Discussion 32. i) Implications for Practice 37-41. References 42. Appendix 1) – The Four Stages of Research 43. Appendix 2) – Database Search (Hard Copy Only) 44-49. Appendix 3) – Example (1) Using the CASP Framework 50-55. Appendix 3) – Example (2) Using the CASP Framework 56. Appendix 4) – Summary of Studies (Hard Copy Only) 57. Appendix 5) – Intracranial Pressures 58. Appendix 6) – Type 1 & 2 Errors 59. Appendix 7) – The Hawthorne Effect 60. Appendix 8) – The Glasgow Outcome Score 61. Appendix 9) – The Hierarchy of Evidence ABSTRACT Medically induced hypothermia has been used as a neuro-protector to try and limit the consequences of severe brain injury for more than fifty years but it is only recently that its effectiveness has been assessed using randomised controlled trials. Under certain circumstances clinically induced hypothermia has already been proven to be beneficial by providing a degree of neuroprotection in post-cardiac arrest patients. As such it has recently been incorporated into the UK resuscitation guidelines. However, its benefits for treating severe head injury remain debateable. Hypothermia’s main accepted property in head injury is its ability to reduce intracranial hypertension. Prolonged intracranial hypertension is a precursor closely associated with poor outcome and death as it generally reflects the severity of the injury....
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...of the data that has been collected over the years through experimentation, literature reviews, qualitative research, and the results that have been construed from that data will be presented. It discusses the concept of the effects of bariatric surgery and answers the question - do people who have the surgery have better health outcomes, specifically with hypertension and type II diabetes mellitus, than those who do not? A summary of research reveals that there is a significant reduction and/or total remission of both of these co-morbidities that were often life long. Other benefits, such as quality of life, social standings, and healthcare cost reduction are examined and positively reported. Review of current data to include strengths and weaknesses, conceptual frameworks, and the current state of knowledge reveal that bariatric procedures have shown the efficacy and safety in the treatment of morbid obesity and have gained wider acceptance in the medical world. Synthesis of Bariatric Surgery and the Effects on Comorbidities For years people have turned to diets in an effort to lose weight and get healthier. At no time has that been more the case than in America today. People spend billions of dollars a year trying to lose weight and the numbers are not encouraging. The prevalence in obesity with related Type II Diabetes and Hypertension is growing at an alarming rate, calling for other alternatives such as crash diets and extreme exercise plans...
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...Disease Control and Prevention, 2017). Therefore, patients should be taught the importance of following a strict diabetic diet and losing weight. In addition, research has shown that behavioral modifications are more effective than medicinal measures. For instance, healthcare providers can prescribe metformin to prevent the development of type 2 diabetes as well. However, metformin reduces the risk of type 2 diabetes less dramatically than behavioral modifications (National Institute of Diabetes and Digestive and Kidney Diseases,...
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...treat Alzheimer’s through disease modification versus only treating the symptoms. In this paper I will discuss other methods scientists are researching for the diagnosing and treatment of Alzheimer’s. According to medical news today, Anavex Life Sciences Corporation has been testing a new neuroprotective, anti-amnesic, anti-depressive and anti-convulsive compounds. ANAVEX 2-73 and ANAVEX 1-41 are being studied for their anti-amnesic and neuroprotective effects, the company claims that these compounds could be compared to donepezil, which is the leading Alzheimer’s disease medication. Researchers are excited about the potential of this possible new Alzheimer’s medication. A clinical trial has been started in which volunteers between the ages of 18 and 55. The volunteers will be given one dose of oral ANAVEX 2-73 to determine the maximum tolerated single dose, safety, and pharmacokinetics with the objective is to evaluate the safety and tolerability of this potential new Alzheimer’s medication. The existing anti-seizure drug, levetiracetam, which improves memory and brain function in adults with a cognitive impairment, which sometimes leads to Alzheimer’s disease, according to a Johns Hopkins University study. Researchers have found that this drug has already used for epilepsy patients and if used for Alzheimer’s patients may slow the abnormal loss of brain function in some aging patients, but more studies are needed before the drug can be used for...
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...disorder. Discuss the usual age of disease onset and if the sex-specific threshold model fits the disorder. What education could you present to high-risk patients to reduce the risk of disease onset if a multifactorial component exists? Question 2= Genetic screening has become widely available to the public including prenatal screening of the fetus in utero to screening adults for genetic disorders, such as Parkinson's disease and breast cancer. Share your thoughts on the legal, ethical, and social implications that may be related to genetic screening. How would you educate your patient that is considering having genetic screening? Week 2: Question 1= Choose an FDA-approved prescription medication and discuss the pharmacokinetics and pharmacodynamics of the medication, including any differences that would be expected based on the patient's age, a condition of pregnancy, or lactation. Address any adverse effects the medication may have based on age, pregnancy, or lactation. Question 2= Active acquired immunity can be achieved through the use of childhood immunizations. Many parents voice concerns regarding the safety of vaccinations. What is your opinion on the current use of vaccinations? How would you educate parents regarding the safety and effectiveness of vaccinations? Defend your answers with evidence-based research. Week 3: Question 1= Share a case study of an electrolyte imbalance from your practice or from the...
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...Population and Self-Awareness Paper NUR/440 – Health Assessment and Promotion For Vulnerable Population 12 December 2011 Vulnerable Populations and Self Awareness Introduction This paper is a study of the vulnerable population of the elderly in the United States and will discuss the mindfulness of this author’s personal biases, attitudes, and conceived stereotypes regarding this population. The patient chosen as an example for this paper is Norma James from the University of Phoenix “neighborhood”. Mrs James is a widow who’s vulnerability relating to health care will be compared with information gathered through research and applied to the elderly population and those with chronic illness. The vulnerabilities faced by Norma will be a realistic representation of the challenges associated with this population. Elderly Patients with Chronic Illness Despite the efforts of healthcare providers and various organizations across the United States to reduce or eliminate disparities within vulnerable healthcare populations, significant disparities continue to cause limited access to healthcare. This limitation poses risk to populations such as elderly and those living in poverty. The health domains of vulnerable populations can be divided into 3 categories: physical, psychological, and social. Those with physical needs include the elderly, chronically ill and disabled, chronic medical conditions include respiratory diseases, diabetes, hypertension, dyslipidemia, and heart disease...
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...be linked to the fear of social discrimination and the possibility of being treated differently if the healthcare providers are predominately white. The health disparities among African Americans today is something that cannot be ignored and is something that healthcare professionals need to take seriously. This paper will talk about the health disparities among African Americans and how we can make change to this by approaching the problem with health promotion and prevention techniques. According to the Centers for Disease Control and Prevention, 2015, the population of African Americans is estimated to be a 45 million; which is 15.2 percent of the United States population. Around 14.7 percent of the African American populations are shown statistically to live in fair or poor health. This particular race is known to suffer from high incidences of Heart Disease, hypertension, diabetes, obesity, poverty and high crime rate. All of these health disparities are either the cause of genetic predisposition, lack of education or financial issues. Healthcare providers need to be aware of this minority groups disadvantages and be able to promote health with these patients and educate them so they can properly prevent future complications. Such complications can go as far as End Stage Renal Disease which is a common...
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...Running head: HEALTH PROMOTION Health Promotion: Reduction of Stroke Deaths Jeffrey M. Heist Indiana State University Introduction The development of health care policy in the United States has historically, been based on the fact that clinicians were responsible to treat primary illness rather than the promotion of health as it related to personal health behaviors (U.S. Preventative Services Task Force, 2011). This paper will examine the Healthy People 2020 objective HDS-3, Reducing Stroke Deaths (U. S. Department of Health and Human Services, 2011), and how the promotion of this objective has progressed since it’s Healthy People 2010, 12-7, predecessor. History The Healthy People initiative was introduced in 1979, by the Department of Health and Human Services (DHHS), in an effort to provide a systematic approach to improving health (Koh, 2010). The plans, known as HP 1990-Promoting Health/Preventing Disease (Centers for Disease Control, 2011), Healthy People 2000, Healthy People 2010 and the current Healthy People 2020 have focused on identifying health priorities and aligning the strategies to effectively implement those strategies. The goals related to each version of the initiative have changed, as have the number of objectives/measures. HP 1990 goals were to decrease mortality in infants and adults and to increase the independence among older adults while the Healthy People 2020 goals were aimed at: ...
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...Family Health Promotion in Nursing Practice February 22, 2014 Family Health Promotion Health promotion is defined as the science and art of helping people improve their lifestyle to move toward a state of optimal health (Edelman & Mandle, 2010). The World Health Organization (WHO) believes health promotion allows health to be a resource and not the objective of living (WHO, 2012). This paper will review the purpose of health promotion as related to nursing practice, and how nursing roles and responsibilities have evolved in regards to health promotion and implementation on the prevention, management and long term maintenance and rehabilitation on Stroke patients, including preventing education to the public and communities, on a primary, secondary, and tertiary prevention level (Edelman & Mandle, 2010). A stroke is caused by the disruption of the blood supply to the brain, usually related to a blood vessel ruptures or blocked by a clot, as define by World Health Organization. The blockage of oxygen and nutrients to the brain’s tissues can cause permanent damage to the brain tissue. Warning signs of stroke are, sudden weakness or numbness of the face, arm or leg, most often on one side of the body. Other symptoms include: confusion, difficulty speaking or understanding speech; difficulty seeing with one or both eyes; walking, dizziness, loss of balance or coordination; severe headache with no known cause; fainting or unconsciousness. The effects of a stroke...
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...several risk factors. Triglyceride level of Mr. Ward is 1.8mmol/l which is considered to be borderline high. Likewise, the cholesterol is 5.2mmol/l which again is very high. He also has a blood pressure higher than a safe range and a BMI below satisfactory level. This paper aims to highlight the facts and interventions which can be used for disease management for Mr Ward. Discussion The major challenge for maintaining a suitable glycemic control for diabetic patients is to restrict the progression of disease or development of the risk factors which turn pertinent over the course of time. The progression of disease can be restricted through considering the factors leading to weight gain, the pharmaceutical considerations, incurrence of glycemic conditions, and by taking into account the inherent restraints for administering exogenous insulin (Nichols et al, 2000). According to Davies (2004), there are number of factors which influences the consultation for diabetes patients amongst which the prominent ones include age, span of diabetes, the BMI, and measure of physical exercise. The glycaemic control remains the first and foremost target for every healthcare provider to enable insulin uptake in patients suffering from type 2 diabetes. Janes et al (2013) have highlighted the significance of daily routine and activities in management of type 2 diabetes. In view of the author, a person’s way of managing the disease is influenced by his own perspectives aside from the medications...
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...Latino/Hispanic Americans, Native Americans, Asian Americans, Alaskan Natives and Pacific Islanders as compared with the US population as a whole." --National Center for Cultural Competence Population addressed Population addressed In 1950, U.S.-born whites made up about 90 percent of the U.S. population. By 2000, this number declined to about 75 percent, and by 2050 non-Hispanic whites will be in the numerical minority (U.S. Census Bureau 2001, 2002). This rapid diversification requires healthcare organizations to pay closer attention to cross-cultural issues if they are to meet the healthcare needs of the nation and continue to maintain a high standard of care. Looking at the Country as a whole the current area of discussion for this paper is the area of Western North Carolina and the population of Asheville, which is a melting pot of cultures which the combination they create is unique to no other. According to the 2006 U.S. Census Bureau statistics for Asheville, N.C. the current demographics break down as follows: Asheville [City] Population (current estimate), 70,400. Buncombe County Population (2006), 222,174, county in Western North Carolina Asheville is located. Gender Dispersion was 46.8% Male, 53.2% Female with an average age being 39.2 years of age. Race breaks down as follows: White persons (2000), 78%, Black or African American persons(2000), 17.6%, American Indian (2000), 0.4%, Asian persons (2000), 0.9%, Hispanic or Latino origin (2000), 3.8% ( underestimated...
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...process is dangerous and can result in the development of cardiovascular problems and even death. This condition is known as sleep apnea. In this respect, an individual with sleep apnea experiences repeated breathing stops for as many as thirty times in an hour when asleep. Such episodes are dangerous for the snorer since it increases the risk of developing heart failure, high blood pressure, stroke, and arrhythmia. Research shows that one in every five people suffers from sleep apnea. America, in particular, has one of the highest incidences of people with the disease. According to Lettieri (2010), about 15 million adults suffer from obstructive sleep apnea in America. The majority of people with sleep apnea are patients with cardiovascular problems and hypertension. As earlier mentioned, this condition is life threatening and require early treatment. This document will examine the historical evidence of the disease, its causes, and its clinical effects on the cardiovascular system, complications, and prognosis. The discourse will also explore the treatments and research associated with the disease. Historical Evidence Javaheri, Caref, Chen, Tong, and Abraham (2011) define sleep apnea as a condition characterized by repeated breathing stops in the snoring process. The episode usually occurs as many as 30 times in an hour. Sleep apnea...
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